HCPCS 97161

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

Other services Work RVU per service 1.54 (2024 fee schedule)

37,020
99th percentile among 6,471 codes billed · 2024
$115M
98th percentile among 6,471 codes billed · 2024
1.6M
97th percentile among 6,471 codes billed · 2024
31
59th percentile among 6,471 codes billed · 2024
111
57th percentile among 6,471 codes billed · 2024
+0.8%
Medicare payment on the code vs 2023; billers +3.6% · 2024

Trend

Medicare payment on the code

$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M

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

Billers

020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K

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
202437,020$114,914,966+1%1,576,730311111.54
202335,745$113,952,457+6%1,533,616311121.54
202234,013$107,363,788+5%1,439,378311101.54
202132,148$102,028,201+50%1,336,170311071.54
202027,736$68,010,739first year in data1,071,37529991.20

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
California3,407$13,424,732172,35337137
New York3,253$11,575,696145,73933115
Florida1,805$8,217,595114,38042177
New Jersey1,854$5,622,20770,9402993
Illinois1,612$4,771,95265,86230103
Texas1,517$4,342,56361,67729104
North Carolina1,318$3,922,23356,52232107
Massachusetts1,205$3,865,11750,96232114
Arizona1,110$3,790,84854,39235138
Pennsylvania1,393$3,762,74051,9172990
Virginia1,114$3,470,20647,59030110
Maryland924$3,382,38143,96636118
Washington1,181$2,939,79240,3922686
Georgia827$2,478,69335,35831113
Tennessee843$2,431,01635,67432111

Not listed: 6 billers with an armed-forces or unknown state code (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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,891$13,633,322168,25132
Los Angeles-Long Beach-Anaheim, CA1,116$3,847,57449,04232
Chicago-Naperville-Elgin, IL-IN1,330$3,715,64350,52828
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD961$2,865,18637,78231
Miami-Fort Lauderdale-West Palm Beach, FL560$2,799,50738,27343
Washington-Arlington-Alexandria, DC-VA-MD-WV875$2,741,14335,21929
Phoenix-Mesa-Chandler, AZ794$2,557,01936,68535
Boston-Cambridge-Newton, MA-NH877$2,545,92433,11929
San Francisco-Oakland-Fremont, CA335$1,481,18917,23936
Dallas-Fort Worth-Arlington, TX535$1,443,54320,17226
Minneapolis-St. Paul-Bloomington, MN-WI697$1,435,06020,45326
Baltimore-Columbia-Towson, MD435$1,425,19018,73631
Seattle-Tacoma-Bellevue, WA598$1,343,67217,97224
San Diego-Chula Vista-Carlsbad, CA405$1,309,61816,95132
Atlanta-Sandy Springs-Roswell, GA483$1,292,99218,00629

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 2024.

Specialties billing 97161 nationally

Physical Therapist in Private Practice accounts for 98% of payment for 97161 nationally in 2024, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice36,45498%$113,024,53098%1,550,73943
Orthopedic Surgery2840.77%$920,4080.80%12,76845
Physical Medicine and Rehabilitation1170.32%$367,7050.32%4,94542
Family Practice300.08%$122,9360.11%1,71657
Neurology130.04%$120,3860.10%1,625125
Internal Medicine140.04%$62,2500.05%83860
Otolaryngology170.05%$40,2900.04%56233
Podiatry160.04%$35,8100.03%46429

Not listed: 17 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 2024.

Top billers of 97161 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