Price Checker / CPT 97597
CPT 97597 — Dbrdmt opn wnd 1st 20 cm/<
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$31
What Medicare pays in a hospital/ASC setting
$102
What Medicare pays in a physician's office
$11,949
Based on 55 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 97597
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Southern Tennessee Regional Health System - Pulaski , TN | $27,258 | — | 26745% |
| Aurora Sinai Medical Center of Aurora Health Care Metro , WI | — | — | 26318% |
| "Aurora St. Luke's Medical Center of Aurora Health Care Metro" , WI | — | — | 26318% |
| "Aurora St. Luke's South Shore of Aurora Health Care Metro" , WI | — | — | 26318% |
| Aurora Baycare Medical Center , WI | — | — | 22019% |
| Aurora Lakeland Medical Center , WI | — | — | 22019% |
| Aurora Medical Center Burlington , WI | — | — | 22019% |
| Aurora Medical Center Fond du Lac , WI | — | — | 22019% |
| Aurora Medical Center Grafton , WI | — | — | 22019% |
| Aurora Medical Center Kenosha , WI | — | — | 22019% |
| Aurora Medical Center Manitowoc , WI | — | — | 22019% |
| Aurora Medical Center Mount Pleasant , WI | — | — | 22019% |
| Aurora Medical Center Oshkosh , WI | — | — | 22019% |
| Aurora Medical Center Sheboygan County , WI | — | — | 22019% |
| Aurora Medical Center Summit , WI | — | — | 22019% |
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About CPT 97597
CPT code 97597 refers to “Dbrdmt opn wnd 1st 20 cm/<”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $31 in a facility (hospital or ambulatory surgery center) and $102in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.