HCPCS 97530

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

Other services Work RVU per service 0.44 (2021 fee schedule)

47,233
100th percentile among 6,253 codes billed · 2021
$649M
100th percentile among 6,253 codes billed · 2021
23.1M
100th percentile among 6,253 codes billed · 2021
292
93rd percentile among 6,253 codes billed · 2021
1,575
92nd percentile among 6,253 codes billed · 2021
+40.7%
Medicare payment on the code vs 2020; billers +22.3% · 2021

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
California3,918$69,678,6652,397,5413052,140
New York3,399$66,478,9192,080,5983711,896
New Jersey2,790$52,533,1851,706,6514231,810
Illinois2,697$35,301,0421,231,8573081,335
Florida1,934$32,590,4901,181,5302872,075
Pennsylvania1,734$24,164,207859,0033191,446
Maryland1,640$22,886,496759,0922901,490
Texas1,727$22,735,447856,6992721,513
South Carolina1,024$22,254,264875,7936052,405
Virginia1,497$21,791,079773,6573081,607
Arizona1,446$21,723,446815,8323511,766
Washington1,839$19,677,042715,6952411,222
Georgia1,470$18,019,557671,0963231,339
North Carolina1,474$15,715,492590,5992441,234
Tennessee1,247$14,978,569579,1273261,336

Not listed: 7 billers with an armed-forces or unknown state code (AA, AE, ZZ); they are in the national totals.

Not listed: 1 state 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-NJ4,537$89,095,5072,758,235385
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,829$34,565,2091,184,731476
Chicago-Naperville-Elgin, IL-IN2,315$30,058,6561,034,173315
Los Angeles-Long Beach-Anaheim, CA1,266$22,396,903755,340274
Washington-Arlington-Alexandria, DC-VA-MD-WV1,248$15,808,270520,998267
Phoenix-Mesa-Chandler, AZ1,039$14,603,995546,076353
Baltimore-Columbia-Towson, MD849$11,494,683383,716280
San Diego-Chula Vista-Carlsbad, CA579$11,276,092411,144389
Seattle-Tacoma-Bellevue, WA1,086$11,041,211391,403245
Atlanta-Sandy Springs-Roswell, GA915$10,926,669398,115313
Miami-Fort Lauderdale-West Palm Beach, FL494$10,319,326364,357352
Boston-Cambridge-Newton, MA-NH875$9,902,292325,507243
Detroit-Warren-Dearborn, MI883$9,443,241334,723280
Dallas-Fort Worth-Arlington, TX597$6,858,182255,438272
Kansas City, MO-KS485$6,720,242259,490361

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 97530 nationally

Physical Therapist in Private Practice accounts for 85% of payment for 97530 nationally in 2021, across 15 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice40,92087%$549,465,09785%19,498,879477
Occupational Therapist in Private Practice5,48012%$92,173,18314%3,335,517609
Orthopedic Surgery3270.69%$2,221,2110.34%78,396240
Physical Medicine and Rehabilitation1200.25%$1,257,6830.19%42,010350
Family Practice410.09%$597,1810.09%21,647528
Speech Language Pathologist290.06%$481,3820.07%18,924653
Nurse Practitioner440.09%$467,4950.07%20,875474
Internal Medicine320.07%$337,2070.05%11,155349
Neurology240.05%$225,4810.03%8,386349
Hand Surgery520.11%$222,8760.03%7,783150
Interventional Pain Management160.03%$222,6240.03%8,329521
Optometry140.03%$162,1970.02%5,817416
Otolaryngology260.06%$138,9520.02%5,025193
Physician Assistant110.02%$88,5550.01%3,444313
Podiatry130.03%$58,524<0.01%1,831141

Not listed: 23 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 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