go back

Pennsylvania rates for HCPCS 97598

Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $977 · 10th–90th $49–$7,2440%5%10th90th$977Professionalmedian $39 · 10th–90th $13–$1200%10%10th90th$39$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $977.24 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $38.02 / $123.03
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $43.65 / $45.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $31.62 / $81.28
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $81.28
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $63.10 / $91.20
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $338.84 / $389.05
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $1,584.89 / $6,165.95
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $38.90 / $91.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $74.13 / $100.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $31.62 / $50.12
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $31.62 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $38.90 / $70.79