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Payers: V.A.C.® Therapy: CPT Codes for NPWT
CPT Codes for NPWT
Effective January 1, 2006, physicians and certain other healthcare practitioners using V.A.C.® Therapy may be eligible for reimbursement for services associated with Negative Pressure Wound Therapy (NPWT).  V.A.C.® Therapy is verified by the Centers for Medicare and Medicaid Services (CMS) to deliver NPWT.
 
 
The Centers for Medicare and Medicaid Services (CMS) has assigned Relative Value Units (RVUs) to NPWT CPT codes assigned by the American Medical Association’s (AMA).  Details concerning reimbursement for services performed by healthcare practitioners using V.A.C.® Therapy are included in the CMS 2006 Physician’s Fee Schedule final rule, which can be accessed through the CMS Website.  Healthcare practitioners who are eligible to seek reimbursement under the NPWT CPT codes are determined by state regulations that dictate what types of procedures each practitioner can perform.

What are the CPT codes for NPWT?

CPT Code

Wound Size

Relative Value Units
(RVUs)

97605

< or = 50 cm2
in surface area

0.55

97606

> 50 cm2
in surface area

0.60

What reimbursement has been assigned to each of the codes?

CMS assigned 0.55 work Relative Value Units (RVUs) to code 97605 and 0.60 work RVUs to code 97606. RVUs are used to calculate the payment to providers. The calculation of the specific amount of reimbursement using the RVUs can vary depending on the geographic location within the US and practice costs within that location. Payment calculations are now posted on the  CMS website.

Where can I get further information about the NPWT CPT codes?

You can access information on the CMS Website, the AMA Website and by calling the KCI Reimbursement Helpline at 1-800-275-4524 extension 56008 for further information.

The information contained in this website is provided for informational purposes only and represents no statement, promise or guarantee by KCI concerning the levels of reimbursement, payment, calculations, eligibility, charge or that these codes will be appropriate for specific services provided or that reimbursement will be made. KCI recommends that you consult your local CMS contracted carrier or other applicable payor organization with regard to specific reimbursement policies, coverage, payment and criteria. Individual circumstances and situations may vary.

CPT® is a trademark of the American Medical Association. Current Procedural Terminology © 2005 American Medical Association. All Rights Reserved.