Understanding Quad-Wave Class IV Laser Therapy
Photobiomodulation (PBM) is the foundation of Class IV laser therapy — a scientifically validated mechanism by which specific wavelengths of light stimulate cellular repair, reduce inflammation, and accelerate healing at the molecular level. This page explores the science, technology, and clinical applications that make the REMY FX platform the most comprehensive quad-wavelength laser therapy system available.
Laser therapy delivers infrared electromagnetic energy as photons into the body. These photons are absorbed by chromophores — light-sensitive molecules — within cells and mitochondria. The primary chromophore for therapeutic lasers is Cytochrome C Oxidase, a key enzyme in the mitochondrial electron transport chain.
When photons are absorbed by Cytochrome C Oxidase, they stimulate the production of ATP (adenosine triphosphate) — the universal energy currency of living cells. Increased ATP production drives a cascade of biological responses that promote healing, reduce pain, and accelerate tissue repair. Different wavelengths optimize different parts of this process. A single wavelength can only target a narrow range of tissue depths and chromophores. Four wavelengths working simultaneously create a synergistic effect that no single- or dual-wavelength system can match.
Modulation of pain signals through endorphin release, gate control theory activation, and reduced nerve sensitivity. Laser therapy interrupts pain pathways at the peripheral and central nervous system level, providing both immediate and lasting analgesic effects.
Decreased inflammatory mediators (prostaglandins, interleukins, TNF-alpha) and improved lymphatic drainage. PBM reduces edema, calms the inflammatory response, and restores normal tissue homeostasis at the cellular level.
Enhanced cell metabolism, collagen synthesis, and tissue repair through increased fibroblast activity and protein production. ATP-driven cellular energy boosts every phase of the healing cascade — from inflammation through remodeling.
Vasodilation, angiogenesis (new blood vessel formation), and enhanced microcirculation deliver more oxygen and nutrients to damaged tissue. Nitric oxide release relaxes blood vessel walls, improving blood flow to ischemic areas.
Axonal growth stimulation, improved nerve function, and neuropathy recovery. PBM promotes Schwann cell proliferation and nerve growth factor expression, supporting regeneration of damaged peripheral nerves and restoring sensation.
Decreased fibrous tissue formation and enhanced tissue remodeling. PBM promotes organized collagen deposition rather than disorganized scar formation, improving tissue quality, flexibility, and functional outcomes post-injury.
Every wavelength of light interacts with tissue differently. The REMY FX combines four complementary wavelengths — each targeting different chromophores, tissue depths, and biological mechanisms — to deliver the most comprehensive therapeutic coverage available in a single system.
One of the strongest anti-inflammatory wavelengths available. The 650nm red laser excels at treating superficial tissues and skin conditions. It provides anti-bacterial, anti-viral, and anti-herpetic properties, making it uniquely versatile for dermatological applications. Also serves as a precision aiming beam since infrared wavelengths are invisible.
This wavelength is particularly popular in chiropractic for neurological applications and energy pathway tracing on the scalp and body. It stimulates elastin production for skin rejuvenation and wound care, and is effective for lymphatic system stimulation.
The 810nm wavelength is considered the gold standard for Photobiomodulation (PBM), favored by European specialists including Dr. Weber and Dr. Michael Hamblin. It provides the ideal combination of penetration depth and photo-chemical reaction, maximizing interaction with Cytochrome C Oxidase in mitochondria for optimal ATP production.
This wavelength improves oxygen delivery by activating hemoglobin binding to oxygen in red blood cells. It facilitates critical calcium distribution within cells and mitochondria — a key mechanism in cellular signaling and repair. The 810nm wavelength is the primary driver of long-term tissue regeneration and healing.
The 980nm wavelength is the gold standard wavelength for most Class IV laser systems — and for good reason. It is highly absorbed by hemoglobin and water, converting energy efficiently into therapeutic heat for superior analgesic pain relief. This is the wavelength that delivers the immediate “I feel better” response patients love.
It interacts strongly with water molecules naturally present in soft tissue, supporting microcirculation and reducing inflammatory fluid. The 980nm wavelength affects calcium distribution by decreasing calcium within mitochondria and increasing it in cell liquid — a mechanism distinct from 810nm that provides complementary therapeutic benefit.
The 1064nm wavelength is the secret weapon of the REMY FX platform — and the wavelength most competitors simply don't have. LightForce? No 1064nm. Summus? No 1064nm. This wavelength achieves 4-6 inches of tissue penetration, reaching deep musculoskeletal structures including hips, knees, shoulders, spine, and major muscle groups that shorter wavelengths cannot access.
Because 1064nm has minimal melanin absorption, it delivers consistent results across ALL skin types — including melanin-rich skin where other wavelengths experience significant surface scatter. It stimulates deep collagen production, activates metabolic processes in the deepest tissues with minimal heat buildup, and emerging research suggests it may enhance cognitive performance and upregulate cerebral oxygen metabolism.
Different conditions require different tissue depths and different biological mechanisms. A system limited to 2 wavelengths simply cannot treat the full spectrum of clinical presentations. Here is how the REMY FX compares.
No superficial treatment (no 650nm for skin conditions, wound care, or dermatology). No deep penetration (no 1064nm for hips, spine, or deep joints). Cannot treat skin conditions. Cannot reach deep structures like hips and spine effectively. Significant therapeutic gaps at both ends of the depth spectrum.
Has surface coverage but uses 915nm instead of 1064nm. Cannot reach deepest tissues. Maximum penetration approximately 3-4 inches. Misses the deep joint, spine, and major muscle group treatments that 1064nm enables. The 915nm wavelength provides marginal additional benefit over 980nm due to similar absorption characteristics.
Complete coverage from skin surface to 6 inches deep. Treats every condition at every depth in a single session. The only affordable system with true full-spectrum quad-wave capability at this power level. Each wavelength is optimized for a different chromophore and tissue depth, creating unmatched synergistic therapeutic effect.
The REMY FX gives you full control over energy delivery with two distinct operating modes. Understanding when to use each mode — and how to combine them — is the key to optimizing treatment outcomes for every patient.
In Continuous Wave mode, the REMY FX delivers a steady, uninterrupted beam of laser energy at the selected power level. The laser output remains constant for the entire treatment duration, providing maximum energy transfer to the tissue. CW mode is ideal when you need to deliver the highest therapeutic dose in the shortest time.
CW mode excels at supporting circulation and cellular metabolism through consistent photon delivery. It is the preferred mode for chronic conditions, deep tissue treatment, and when maximum joule delivery is the priority. At full 60W continuous output, the REMY FX 90W delivers 3,600 joules per minute (the 45W model delivers 1,620 J/min).
In Repeat Pulse mode, the REMY FX delivers rapid bursts of laser energy with precisely controlled intervals between pulses. This allows the tissue to cool slightly between energy deliveries, preventing thermal buildup while maintaining therapeutic efficacy. Pulse mode reaches 90W peak power on the 90W model (45W on the 45W model) — significantly higher than CW mode.
Pulsed delivery is critical for acute injuries, areas with high water content, and sensitive tissues where thermal management is important. The adjustable repetition rate (0.2 Hz to 50 kHz) and up to 12 independent frequency sweeps give you granular control over energy delivery patterns to match any clinical scenario.
Both REMY FX models provide infinitely variable programming, giving you precise control over every aspect of treatment delivery. You can program treatments from Class 3b levels all the way up to full peak power — and everything in between.
The REMY FX quad-wavelength platform addresses the broadest range of clinical conditions of any Class IV laser system. Both the 90W and 45W models treat all conditions listed below — the 90W simply delivers energy faster for shorter treatment times.
100+ pre-loaded multiphase protocols with the ability to create unlimited custom treatments. Below are recommended wavelength combinations and session counts for common conditions.
| Body Region | Condition | Wavelengths | Sessions | Notes |
|---|---|---|---|---|
| Head/Neck | TMJ | 810nm + 980nm | 6-10 | — |
| Head/Neck | TBI | 810nm + 1064nm | 10-20 | Emerging research |
| Head/Neck | Migraine | 810nm + 980nm | 6-12 | — |
| Shoulder | Rotator Cuff | 980nm + 1064nm | 6-12 | — |
| Shoulder | Frozen Shoulder | 810/980/1064nm | 8-15 | Multi-wavelength key |
| Elbow | Tennis Elbow | 810nm + 980nm | 6-10 | — |
| Hand/Wrist | Carpal Tunnel | 810nm + 980nm | 6-12 | — |
| Hand/Wrist | Arthritis | 810/980/1064nm | 8-12 | — |
| Spine | Disc Herniation | 980nm + 1064nm | 8-15 | Deep penetration key |
| Spine | Sciatica | 980nm + 1064nm | 8-15 | — |
| Spine | Stenosis | 810/980/1064nm | 10-20 | — |
| Hip | Bursitis | 980nm + 1064nm | 6-10 | — |
| Hip | Osteoarthritis | 810/980/1064nm | 8-15 | — |
| Knee | ACL/MCL | 810nm + 980nm | 6-12 | Post-surgical too |
| Knee | Meniscus | 810/980/1064nm | 6-12 | — |
| Ankle/Foot | Plantar Fasciitis | 810nm + 980nm | 6-10 | Very responsive |
| Ankle/Foot | Achilles Tendinitis | 810nm + 980nm | 6-10 | — |
| Ankle/Foot | Onychomycosis | 650nm + 1064nm | 4-8 | FDA cleared |
| General | Neuropathy | 810/980/1064nm | 10-20 | — |
| General | Fibromyalgia | 810nm + 980nm | 12-24 | Multi-area treatment |
| General | Post-Surgery | 650/810/980nm | 4-8 | Accelerates healing |
| General | Wound Care | 650nm + 810nm | Variable | Burns too |
| General | Scar Tissue | 650/810/980nm | 6-12 | — |
Generate revenue through insurance billing and cash-pay models. Here are the primary CPT codes used for Class IV laser therapy services.
| CPT Code | Description | Typical Use | Rate Range |
|---|---|---|---|
| 97039 | Unlisted Modality | Most commonly used for Class IV laser. Per 15-min unit. | $50–$150/unit |
| 0552T | Low-Level Laser Therapy (LLLT) | Specific PBM code. Growing acceptance. | $75–$200/session |
| 97026 | Infrared Therapy | Application of infrared modality. Per 15-min unit. | $30–$75/unit |
| 97140 | Manual Therapy Techniques | When laser combined with manual techniques. | $40–$100/unit |
The REMY FX platform is manufactured by Zuckerman Future Technologies (ZFT), fully FDA 510(k) cleared, and built to the highest international safety standards. Class IV laser therapy has an excellent safety profile when used by trained practitioners.
The REMY FX is a Class II Medical Device cleared by the FDA on May 15, 2019. It is indicated for topical heating to provide temporary relief of minor muscle and joint pain, stiffness, arthritis pain, muscle spasm, to temporarily increase blood circulation, and to temporarily relax muscles. Additionally cleared for podiatric soft tissue procedures and treatment of onychomycosis.
Ready to bring the most advanced quad-wavelength Class IV laser therapy system to your practice? Explore both models or request a personalized consultation.
FDA 510(k) K190034 | Class II Medical Device | Prescription Use Only
Since purchasing The Remy, I have already started seeing positive results in my patients. They are very happy to have an alternative to invasive surgeries.
We have been using The Remy for plantar fasciitis and Achilles tendonitis. It’s been great not to have to send patients out for physical therapy anymore.
Plus, laser therapy is so easy for me to administer with The Remy. It’s lightweight and the screens are easy to navigate.
With the ability to treat pain, fungus, and perform certain surgical procedures, choosing laser therapy for my practice has been one of the best investments I have made in a long time!
I am still in practice after 50 years . I am using The Remy for pain and toenail fungus. The only complaint I have is that I wish I had introduced The Remy into my practice years ago! The Remy is one of the major breakthroughs in the treatment of podiatric pain conditions such as plantar fasciitis and Achilles tendonitis, as well as pain and inflammation.
I have had the pleasure of calling Dr. David Zuckerman, (Founder of the REMY laser) my business partner at Excellence Shock Wave Therapy for almost 20 years. David has a passion for learning and investing in technology that offers new solutions for patients, and opportunities for doctors. One thing I have seen over the years is the deep-dive David takes on learning new technology and ferreting out the true quality from over hyped medical devices. It has been one of the greatest privileges in my life to work with doctors in their office to bring the solution of high energy ESWT to patients. Nothing is more rewarding than seeing patients have relief from their pain. David and I each bring different things to the table in our company, and I know I couldn’t have had a better Medical Partner (and friend) on this journey.
I've had the Remy for a little over a month and have been loving it. It's extremely easy to use and even quicker to learn, it was so simple to get up and running but honestly I credit that to the team who helped me. I've been able to get treatments myself and have seen a drastic improvement after personally getting surgery and using the laser in addition to using pulse wave. these are extremely powerful machines that I'm extremely impressed by the quick improvement I've seen in being the patient myself. The inflammation in my leg has gone down SIGNIFICANTLY, so much so that I was able to heal 2 weeks faster than projected, my incision is closing up even faster. As a patient, it feels warm and extremely comfortable. I'd easily recommend this to anyone who's considering laser therapy especially as it's the least expensive on the market compared to K Laser, Lightforce or Aspen.
