Soft tissue repair · Foot & ankle

97597

Selective removal of devitalized tissue from an open wound surface, such as slough or fibrin, for the first 20 square centimeters or less of wound area.

3 sources ↓

Medicare
$101.54
Work RVU
0.75
Global, days
0
Region
Foot & ankle
Drawn from CMS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 3 cited references ↓

  • Wound location and measurements (length, width, depth)
  • Tissue type removed (slough, fibrin, exudate)
  • Instrument used
  • Depth of debridement confirming surface only
  • Total surface area debrided
  • Wound appearance after debridement

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 3 cited references ↓

97597 is selective debridement of an open wound, removing dead or devitalized tissue from the wound surface with instruments like scissors, a scalpel, or forceps. It covers the first 20 sq cm or less. Larger areas use the add-on 97598. It carries a 0-day global.

Ortho and podiatry practices use it for diabetic foot ulcers, pressure wounds on the heel, and superficial breakdown around a post-op incision. Physicians, NPs, PAs, and therapists can bill it within scope.

Where claims go wrong: depth decides the code. If tissue is removed down to subcutaneous tissue, muscle, or bone, the 11042 to 11047 series applies instead. Do not bill both for the same wound. Add up the surface area of all wounds debrided at the same depth before picking units. In the global period after surgery, routine care of the surgical incision is included in the surgical package. Document wound location, size before and after, tissue removed, instrument, and depth.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (0.75) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (3.04) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU 0.75
Practice expense RVU 2.24
Malpractice RVU 0.05
Total RVU 3.04
Medicare national rate $101.54
Global period 0 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$101.54
HOPD (APC 5051)
Hospital outpatient department
$204.98

Common denial reasons

The recurring reasons claims for CPT 97597 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

  • Billed with 11042 to 11047 for the same wound
  • Surface area not documented
  • Debridement of surgical incision during global period
  • Depth documented beyond surface level
  • Missing modifier for separate wound sites
  • E/M billed same day without modifier 25

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 3 cited references ↓

01When should I use 97597 instead of 11042?
Use 97597 when only surface tissue is removed. If you debride into subcutaneous tissue or deeper, use 11042 or higher.
02How do I count area for multiple wounds?
Add the surface area of all wounds debrided at the same depth, then bill 97597 for the first 20 sq cm and 97598 for each additional 20 sq cm.
03Can a physical therapist bill 97597?
Yes, within state scope, with GP on Medicare claims.
04Is incision debridement in the global period billable?
Routine care of the surgical wound is part of the global package. A separate complication may need modifier 79 or other review.

Sources & references

Editorial content was developed using the following public sources.

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/medicare/payment/fee-schedules/physician
  3. 03
    cms.gov
    https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits

Mira Scribe

Mira Scribe captures wound site, size, tissue removed, and depth in the note, which are the four facts a reviewer uses to confirm 97597 over the deeper debridement codes.

See how Mira captures CPT 97597 documentation

Related CPT codes

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