HCPCS 97112

Other service (ClaimLight category; the code descriptor is not shown)

Other services Work RVU per service 0.50 (2021 fee schedule)

50,279
100th percentile among 6,253 codes billed · 2021
$504M
100th percentile among 6,253 codes billed · 2021
20.9M
100th percentile among 6,253 codes billed · 2021
253
93rd percentile among 6,253 codes billed · 2021
1,303
90th percentile among 6,253 codes billed · 2021
+34.0%
Medicare payment on the code vs 2020; billers +18.7% · 2021

Trend

Medicare payment on the code

$0$500M2020: $376M paid20202021: $504M paid20212022: $552M paid20222023: $630M paid20232024: $707M paid2024$707M$0$500M2020: $376M paid20202021: $504M paid20212022: $552M paid20222023: $630M paid20232024: $707M paid2024$707M$0$500M2020: $376M paid20202021: $504M paid20212022: $552M paid20222023: $630M paid20232024: $707M paid2024$707M$0$500M2020: $376M paid20202021: $504M paid20212022: $552M paid20222023: $630M paid20232024: $707M paid2024$707M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

025K50K2020: 42K providers20202021: 50K providers20212022: 56K providers20222023: 62K providers20232024: 68K providers202468K025K50K2020: 42K providers20202021: 50K providers20212022: 56K providers20222023: 62K providers20232024: 68K providers202468K025K50K2020: 42K providers20202021: 50K providers20212022: 56K providers20222023: 62K providers20232024: 68K providers202468K025K50K2020: 42K providers20202021: 50K providers20212022: 56K providers20222023: 62K providers20232024: 68K providers202468K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
202467,834$706,760,086+12%33,792,5923111,5450.50
202361,940$630,172,130+14%29,112,8172901,4560.50
202256,003$551,711,341+9%24,323,4442671,3530.50
202150,279$504,155,757+34%20,887,2222531,3030.50
202042,373$376,172,998first year in data15,425,3322211,1370.50

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
New York4,115$59,505,8392,198,5923381,628
California4,105$52,276,6682,056,5972751,611
New Jersey2,907$37,618,0021,465,8653511,431
Florida2,106$29,125,0811,225,0243081,890
Illinois2,992$27,086,0471,132,3042401,118
Pennsylvania2,125$25,064,7121,037,1023481,409
Texas2,094$22,145,961953,0002651,490
Virginia1,590$18,677,074789,1302931,583
Maryland1,658$18,106,540714,1022781,311
Michigan1,684$14,925,059632,0522551,072
Arizona1,335$13,493,214598,2592731,459
Georgia1,435$12,079,796540,2622511,133
Massachusetts1,327$11,853,066464,7992351,014
North Carolina1,479$11,076,800487,444218932
Washington1,614$10,961,062468,068184930

Not listed: 9 billers with an armed-forces or unknown state code (AA, AE, AP, XX, ZZ); they are in the national totals.

Not listed: 2 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ5,535$80,527,9862,990,656356
Chicago-Naperville-Elgin, IL-IN2,621$24,571,9201,023,953250
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,808$22,082,713898,652378
Los Angeles-Long Beach-Anaheim, CA1,464$21,813,152851,276324
Washington-Arlington-Alexandria, DC-VA-MD-WV1,313$13,346,886519,587260
Detroit-Warren-Dearborn, MI961$10,188,746425,506317
Phoenix-Mesa-Chandler, AZ976$10,145,494451,216271
Miami-Fort Lauderdale-West Palm Beach, FL585$10,129,293417,111353
Baltimore-Columbia-Towson, MD856$8,882,858354,448264
Boston-Cambridge-Newton, MA-NH1,064$8,872,264343,863221
Atlanta-Sandy Springs-Roswell, GA924$7,490,516333,822242
Dallas-Fort Worth-Arlington, TX714$6,250,890269,277222
Seattle-Tacoma-Bellevue, WA951$6,100,992259,174186
San Diego-Chula Vista-Carlsbad, CA478$4,792,317193,590245
San Francisco-Oakland-Fremont, CA433$4,405,394161,770224

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing 97112 nationally

Physical Therapist in Private Practice accounts for 93% of payment for 97112 nationally in 2021, across 18 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice46,34792%$467,998,03093%19,348,804417
Occupational Therapist in Private Practice2,7645.5%$24,455,6394.9%1,043,454378
Nurse Practitioner2010.40%$3,746,7100.74%176,534878
Orthopedic Surgery3550.71%$2,111,5350.42%84,037237
Physical Medicine and Rehabilitation1510.30%$1,310,4910.26%50,103332
Internal Medicine640.13%$745,6890.15%28,193441
Family Practice700.14%$697,2770.14%27,704396
Neurology440.09%$429,6320.09%17,647401
Anesthesiology170.03%$421,8860.08%17,0101,001
Physician Assistant220.04%$337,4810.07%16,872767
Otolaryngology550.11%$298,9180.06%13,170239
Podiatry270.05%$266,4810.05%10,428386
Pain Management120.02%$188,3410.04%7,502625
Interventional Pain Management250.05%$128,4330.03%5,327213
Rheumatology130.03%$89,9330.02%3,579275

Not listed: 23 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2021.

Top billers of 97112 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations