HCPCS 97161

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

Other services Work RVU per service 1.54 (2023 fee schedule)

35,745
99th percentile among 6,405 codes billed · 2023
$114M
98th percentile among 6,405 codes billed · 2023
1.5M
97th percentile among 6,405 codes billed · 2023
31
60th percentile among 6,405 codes billed · 2023
112
57th percentile among 6,405 codes billed · 2023
+6.1%
Medicare payment on the code vs 2022; billers +5.1%. 2023 changed hospital and observation visit codes · 2023

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
California3,306$12,969,300164,58135134
New York3,162$11,698,251144,01434115
Florida1,814$8,387,970113,89440184
New Jersey1,745$5,410,69766,9912994
Illinois1,547$4,821,86564,68131107
Texas1,482$4,379,14660,91728106
Arizona1,084$3,812,44153,55534138
North Carolina1,203$3,766,93753,02333112
Massachusetts1,145$3,730,29947,49431113
Pennsylvania1,338$3,711,07950,3323188
Maryland967$3,555,08345,14734112
Virginia1,065$3,395,98345,33431111
Washington1,167$3,079,91341,7832691
Georgia830$2,550,05836,00632115
Ohio782$2,332,01033,26933105

Not listed: 4 billers with an armed-forces or unknown state code (AA, AE, AP, 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,722$13,416,867161,92533
Los Angeles-Long Beach-Anaheim, CA1,105$3,824,92247,84730
Chicago-Naperville-Elgin, IL-IN1,247$3,711,21748,96829
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD930$2,822,76536,39231
Miami-Fort Lauderdale-West Palm Beach, FL564$2,805,10237,31940
Washington-Arlington-Alexandria, DC-VA-MD-WV851$2,688,68633,53630
Phoenix-Mesa-Chandler, AZ776$2,570,43336,07134
Boston-Cambridge-Newton, MA-NH866$2,530,72131,89029
Baltimore-Columbia-Towson, MD459$1,507,41519,33629
Dallas-Fort Worth-Arlington, TX504$1,428,16719,48227
Seattle-Tacoma-Bellevue, WA591$1,379,44318,16723
Minneapolis-St. Paul-Bloomington, MN-WI652$1,378,22419,18526
San Francisco-Oakland-Fremont, CA332$1,366,55916,04933
Atlanta-Sandy Springs-Roswell, GA495$1,291,25117,82328
San Diego-Chula Vista-Carlsbad, CA376$1,152,28914,80030

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 2023.

Specialties billing 97161 nationally

Physical Therapist in Private Practice accounts for 98% of payment for 97161 nationally in 2023, across 13 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice35,05898%$111,696,05198%1,503,70243
Orthopedic Surgery3581.0%$1,179,3121.0%15,70144
Physical Medicine and Rehabilitation1150.32%$383,9930.34%5,05744
Internal Medicine150.04%$124,5320.11%1,633109
Family Practice320.09%$114,0290.10%1,57449
Neurology210.06%$82,3170.07%1,05450
Otolaryngology200.06%$45,1310.04%60330
Occupational Therapist in Private Practice120.03%$38,3630.03%50542
Podiatry160.04%$37,6250.03%46429
Sports Medicine130.04%$35,9450.03%45035
Rheumatology120.03%$28,3960.02%36731
Hand Surgery110.03%$27,1180.02%36233
Neurosurgery120.03%$20,5170.02%26422

Not listed: 13 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 2023.

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