HCPCS 97161

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

Other services Work RVU per service 1.20 (2020 fee schedule)

27,736
99th percentile among 6,116 codes billed · 2020
$68M
97th percentile among 6,116 codes billed · 2020
1.1M
96th percentile among 6,116 codes billed · 2020
29
59th percentile among 6,116 codes billed · 2020
99
56th percentile among 6,116 codes billed · 2020

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% (2023 changed hospital and observation visit codes)1,533,616311121.54
202234,013$107,363,788+5%1,439,378311101.54
202132,148$102,028,201– (Not compared: 2021 changed office visit values)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
California2,537$6,959,923103,18330106
New York2,347$6,117,65387,6532994
Florida1,426$5,322,37783,83941173
Illinois1,235$2,849,93144,4132888
New Jersey1,276$2,818,61440,4272572
Arizona886$2,566,35842,31933123
Texas1,042$2,417,73439,21927100
North Carolina903$2,302,63037,79332107
Pennsylvania1,047$2,212,02834,6672579
Virginia833$2,195,39334,27630103
Washington934$1,964,20031,6182586
Maryland747$1,919,66828,3292997
Massachusetts830$1,846,56627,6082682
Georgia618$1,540,33525,08330109
Tennessee584$1,517,81925,44431120

Not listed: 4 billers with an armed-forces or unknown state code (AA, AE, XX); 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,658$6,703,83393,22027
Chicago-Naperville-Elgin, IL-IN958$2,104,46332,22926
Los Angeles-Long Beach-Anaheim, CA805$2,019,27729,22227
Phoenix-Mesa-Chandler, AZ617$1,629,20726,84232
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD725$1,573,78223,47026
Miami-Fort Lauderdale-West Palm Beach, FL397$1,571,73124,40140
Washington-Arlington-Alexandria, DC-VA-MD-WV643$1,492,99921,71526
Boston-Cambridge-Newton, MA-NH616$1,255,44118,52225
Seattle-Tacoma-Bellevue, WA451$856,75813,50623
San Francisco-Oakland-Fremont, CA289$802,05510,93929
Minneapolis-St. Paul-Bloomington, MN-WI475$796,39612,90724
Baltimore-Columbia-Towson, MD340$784,16611,63027
Atlanta-Sandy Springs-Roswell, GA359$755,85511,99127
Dallas-Fort Worth-Arlington, TX308$722,31811,45025
Providence-Warwick, RI-MA311$652,6749,98127

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 2020.

Specialties billing 97161 nationally

Physical Therapist in Private Practice accounts for 97% of payment for 97161 nationally in 2020, across 13 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice26,90197%$65,917,17897%1,039,07539
Orthopedic Surgery4511.6%$1,181,7961.7%18,20540
Physical Medicine and Rehabilitation1290.47%$301,4280.44%4,68236
Internal Medicine240.09%$95,6340.14%1,47962
Podiatry350.13%$59,8450.09%87525
Family Practice240.09%$59,4440.09%94539
Sports Medicine140.05%$53,2620.08%78956
Hand Surgery210.08%$47,4570.07%75036
Interventional Pain Management170.06%$44,0030.06%66239
Neurosurgery200.07%$42,2670.06%68734
Rheumatology210.08%$36,5060.05%56527
Otolaryngology220.08%$32,7860.05%49022
Neurology130.05%$29,1480.04%44434

Not listed: 14 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 2020.

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