HCPCS 97530

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

Other services Work RVU per service 0.44 (2020 fee schedule)

38,619
99th percentile among 6,116 codes billed · 2020
$461M
100th percentile among 6,116 codes billed · 2020
16.3M
100th percentile among 6,116 codes billed · 2020
245
93rd percentile among 6,116 codes billed · 2020
1,387
91st percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$500M$1.00B2020: $461M paid20202021: $649M paid20212022: $740M paid20222023: $912M paid20232024: $1.06B paid2024$1.06B$0$500M$1.00B2020: $461M paid20202021: $649M paid20212022: $740M paid20222023: $912M paid20232024: $1.06B paid2024$1.06B$0$500M$1.00B2020: $461M paid20202021: $649M paid20212022: $740M paid20222023: $912M paid20232024: $1.06B paid2024$1.06B$0$500M$1.00B2020: $461M paid20202021: $649M paid20212022: $740M paid20222023: $912M paid20232024: $1.06B paid2024$1.06B

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

Billers

050K2020: 39K providers20202021: 47K providers20212022: 55K providers20222023: 63K providers20232024: 70K providers202470K050K2020: 39K providers20202021: 47K providers20212022: 55K providers20222023: 63K providers20232024: 70K providers202470K050K2020: 39K providers20202021: 47K providers20212022: 55K providers20222023: 63K providers20232024: 70K providers202470K050K2020: 39K providers20202021: 47K providers20212022: 55K providers20222023: 63K providers20232024: 70K providers202470K

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
202470,092$1,063,442,995+17%43,562,9193741,9740.44
202362,717$911,698,617+23%36,072,8173441,8270.44
202254,839$740,010,645+14%28,534,1533101,6590.44
202147,233$648,879,561+41%23,095,0112921,5750.44
202038,619$461,229,754first year in data16,295,9482451,3870.44

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
California3,062$47,097,5121,614,1202551,924
New York2,722$43,723,6391,362,8122991,652
New Jersey2,295$35,975,5981,165,9863331,497
Illinois2,307$25,707,248895,2292541,145
Florida1,581$24,563,534874,7352641,951
Pennsylvania1,404$17,849,363628,5022971,334
South Carolina885$17,554,800680,9305232,306
Maryland1,388$16,394,082543,9032371,303
Arizona1,253$16,248,374602,2072941,521
Virginia1,253$15,972,853560,5062551,479
Texas1,256$15,672,530586,3492381,539
Washington1,585$14,822,737533,5001981,076
Georgia1,213$13,280,160484,2062741,171
North Carolina1,175$11,582,521431,2782221,146
Tennessee1,051$10,670,183402,5462601,089

Not listed: 6 billers with an armed-forces or unknown state code (AA, AE, 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,631$57,245,2541,762,601300
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,611$27,610,924937,635418
Chicago-Naperville-Elgin, IL-IN2,009$22,169,916763,592258
Los Angeles-Long Beach-Anaheim, CA956$16,002,346538,111254
Washington-Arlington-Alexandria, DC-VA-MD-WV1,038$11,522,808381,872206
Phoenix-Mesa-Chandler, AZ883$10,660,836392,591298
Baltimore-Columbia-Towson, MD731$8,660,606287,163242
Seattle-Tacoma-Bellevue, WA919$8,092,753283,919202
Atlanta-Sandy Springs-Roswell, GA775$7,982,308284,833253
Miami-Fort Lauderdale-West Palm Beach, FL412$7,822,780271,440299
San Diego-Chula Vista-Carlsbad, CA419$7,166,610261,268325
Boston-Cambridge-Newton, MA-NH691$6,390,959206,931184
Detroit-Warren-Dearborn, MI732$6,195,956218,149214
Kansas City, MO-KS434$5,148,838195,168288
Charleston-North Charleston, SC227$4,654,806181,822619

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 97530 nationally

Physical Therapist in Private Practice accounts for 85% of payment for 97530 nationally in 2020, across 18 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice33,59187%$389,925,21185%13,752,526409
Occupational Therapist in Private Practice4,24011%$65,276,59214%2,331,067550
Orthopedic Surgery3200.83%$2,079,1270.45%72,431226
Physical Medicine and Rehabilitation1220.32%$1,322,4800.29%45,311371
Family Practice330.09%$484,1770.10%16,999515
Speech Language Pathologist240.06%$352,6940.08%13,368557
Internal Medicine340.09%$291,3410.06%9,430277
Neurology200.05%$215,4650.05%8,017401
Nurse Practitioner270.07%$206,7670.04%8,625319
Hand Surgery450.12%$168,0400.04%5,813129
Otolaryngology270.07%$132,6130.03%4,722175
Interventional Pain Management150.04%$77,0490.02%2,730182
Optometry110.03%$74,8130.02%2,852259
Sports Medicine110.03%$74,5880.02%2,387217
Physician Assistant120.03%$62,5070.01%2,607217

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 2020.

Top billers of 97530 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