HCPCS 97161

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

Other services Work RVU per service 1.54 (2021 fee schedule)

32,148
99th percentile among 6,253 codes billed · 2021
$102M
98th percentile among 6,253 codes billed · 2021
1.3M
96th percentile among 6,253 codes billed · 2021
31
60th percentile among 6,253 codes billed · 2021
107
57th percentile among 6,253 codes billed · 2021
–
Not compared: 2021 changed office visit values · 2021

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
California2,927$10,846,784134,36433121
New York2,794$9,867,945118,26033107
Florida1,642$7,612,89899,62841171
New Jersey1,525$4,521,72554,3512883
Illinois1,475$4,467,73058,0392998
Texas1,236$3,648,48149,08930103
Arizona930$3,438,16747,27036137
Pennsylvania1,229$3,436,00844,7922990
North Carolina1,081$3,384,26646,19331114
Virginia995$3,289,97142,68332109
Massachusetts1,034$3,273,17640,3353097
Maryland873$3,088,20437,69732112
Washington1,088$2,940,28639,2212695
Georgia729$2,271,39031,14332106
Ohio705$2,162,63329,71832100

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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,197$10,988,508128,39331
Chicago-Naperville-Elgin, IL-IN1,161$3,316,02342,43827
Los Angeles-Long Beach-Anaheim, CA942$3,195,53338,89530
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD871$2,580,27431,97328
Washington-Arlington-Alexandria, DC-VA-MD-WV785$2,437,15829,27027
Miami-Fort Lauderdale-West Palm Beach, FL463$2,392,09230,53242
Boston-Cambridge-Newton, MA-NH785$2,254,27827,49528
Phoenix-Mesa-Chandler, AZ663$2,238,81630,64734
Seattle-Tacoma-Bellevue, WA541$1,349,32117,47424
Baltimore-Columbia-Towson, MD402$1,277,24215,79629
San Francisco-Oakland-Fremont, CA320$1,214,67713,97233
Minneapolis-St. Paul-Bloomington, MN-WI526$1,193,65915,92626
Dallas-Fort Worth-Arlington, TX402$1,147,95415,29628
Atlanta-Sandy Springs-Roswell, GA422$1,143,06715,28030
Providence-Warwick, RI-MA366$1,040,55313,22631

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 97161 nationally

Physical Therapist in Private Practice accounts for 97% of payment for 97161 nationally in 2021, across 13 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice31,33897%$99,387,36797%1,302,35142
Orthopedic Surgery4481.4%$1,501,3451.5%19,25943
Physical Medicine and Rehabilitation1100.34%$343,0890.34%4,29739
Internal Medicine270.08%$151,3110.15%2,03875
Family Practice250.08%$83,7580.08%1,08143
Interventional Pain Management180.06%$72,9370.07%90150
Otolaryngology260.08%$72,3360.07%93036
Podiatry270.08%$62,5840.06%77029
Sports Medicine130.04%$53,3910.05%63349
Neurosurgery190.06%$41,3590.04%54629
Hand Surgery190.06%$38,1780.04%50226
Neurology140.04%$34,9260.03%44732
Rheumatology140.04%$32,6430.03%41830

Not listed: 16 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 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