HCPCS 97162

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

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

31,861
99th percentile among 6,253 codes billed · 2021
$87M
97th percentile among 6,253 codes billed · 2021
1.1M
96th percentile among 6,253 codes billed · 2021
26
54th percentile among 6,253 codes billed · 2021
91
54th percentile among 6,253 codes billed · 2021
+48.2%
Medicare payment on the code vs 2020; billers +17.6% · 2021

Trend

Medicare payment on the code

$0$50M$100M2020: $59M paid20202021: $87M paid20212022: $91M paid20222023: $97M paid20232024: $98M paid2024$98M$0$50M$100M2020: $59M paid20202021: $87M paid20212022: $91M paid20222023: $97M paid20232024: $98M paid2024$98M$0$50M$100M2020: $59M paid20202021: $87M paid20212022: $91M paid20222023: $97M paid20232024: $98M paid2024$98M$0$50M$100M2020: $59M paid20202021: $87M paid20212022: $91M paid20222023: $97M paid20232024: $98M paid2024$98M

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

Billers

020K40K2020: 27K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 27K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 27K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 27K 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
202436,625$98,071,723+1%1,346,46027941.54
202335,551$97,204,404+7%1,309,32927941.54
202233,634$91,063,796+5%1,220,74727921.54
202131,861$86,789,181+48%1,137,16826911.54
202027,103$58,557,133first year in data916,30325841.20

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
California3,106$10,758,998133,21430112
New York2,244$7,308,49087,43328102
Florida1,411$5,587,46373,59035147
New Jersey1,679$4,591,41754,7762576
Illinois1,636$3,743,70848,1872368
Texas1,307$3,571,39747,73626100
Pennsylvania1,275$3,059,37840,1442570
Maryland993$3,025,72736,7292896
Virginia981$2,911,20737,8652998
North Carolina958$2,504,75334,4202792
Washington1,006$2,471,46233,1282483
Arizona830$2,235,96230,65427100
Georgia913$2,218,36431,5552781
Massachusetts748$2,192,38826,99726100
Michigan1,021$2,103,32627,9712260

Not listed: 6 billers with an armed-forces or unknown state code (AA, AE, XX, ZZ); they are in the national totals.

Not listed: 3 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-NJ2,838$9,150,827106,82727
Los Angeles-Long Beach-Anaheim, CA1,027$3,341,99140,53428
Chicago-Naperville-Elgin, IL-IN1,384$3,146,98640,14223
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD996$2,555,59831,55026
Washington-Arlington-Alexandria, DC-VA-MD-WV746$2,112,36125,43925
Baltimore-Columbia-Towson, MD501$1,456,90217,84526
Boston-Cambridge-Newton, MA-NH586$1,449,56917,75524
Phoenix-Mesa-Chandler, AZ571$1,447,10119,78326
Miami-Fort Lauderdale-West Palm Beach, FL332$1,326,90617,11034
Detroit-Warren-Dearborn, MI614$1,298,18316,78922
San Diego-Chula Vista-Carlsbad, CA389$1,161,50714,71127
Atlanta-Sandy Springs-Roswell, GA534$1,120,07515,86525
Seattle-Tacoma-Bellevue, WA494$1,057,50013,79222
San Francisco-Oakland-Fremont, CA297$962,30811,00328
Dallas-Fort Worth-Arlington, TX380$884,08611,75722

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 97162 nationally

Physical Therapist in Private Practice accounts for 98% of payment for 97162 nationally in 2021, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice31,34898%$85,214,57898%1,117,18536
Orthopedic Surgery2110.66%$643,8640.74%8,25139
Physical Medicine and Rehabilitation990.31%$379,9080.44%4,65847
Internal Medicine280.09%$102,2340.12%1,29846
Family Practice300.09%$83,9280.10%1,11337
Neurology230.07%$73,1590.08%90539
Otolaryngology210.07%$47,3380.05%60529
Interventional Pain Management110.03%$28,9630.03%37934
Podiatry120.04%$28,1390.03%35229

Not listed: 20 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 97162 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