HCPCS 97530

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

Other services Work RVU per service 0.44 (2022 fee schedule)

54,839
100th percentile among 6,326 codes billed · 2022
$740M
100th percentile among 6,326 codes billed · 2022
28.5M
100th percentile among 6,326 codes billed · 2022
310
93rd percentile among 6,326 codes billed · 2022
1,659
92nd percentile among 6,326 codes billed · 2022
+14.0%
Medicare payment on the code vs 2021; billers +16.1% · 2022

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
California4,717$81,828,5172,995,6983242,146
New York3,894$73,778,2662,459,7073911,901
New Jersey3,146$56,057,5341,925,6004171,837
Illinois2,972$40,341,8491,553,1353381,560
Florida2,288$38,125,8021,539,2563132,335
Pennsylvania2,162$29,608,0431,127,9803371,576
Texas2,261$29,110,9661,198,7223001,647
Maryland1,776$25,460,125914,9263371,629
Arizona1,617$23,691,928964,3963891,854
Virginia1,683$22,776,919870,9973221,563
South Carolina1,110$22,344,348960,8896082,467
Washington2,079$22,085,220873,7972491,328
Georgia1,666$20,401,490821,0223421,444
Michigan1,825$18,675,336736,0282601,143
North Carolina1,652$17,812,937728,5762621,445

Not listed: 12 billers with an armed-forces or unknown state code (AA, AE, AP, XX, 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ5,211$98,064,2973,219,408396
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD2,062$36,383,6001,324,608461
Chicago-Naperville-Elgin, IL-IN2,548$33,624,2811,266,712344
Los Angeles-Long Beach-Anaheim, CA1,514$25,958,294936,746289
Washington-Arlington-Alexandria, DC-VA-MD-WV1,397$17,330,470610,044289
Phoenix-Mesa-Chandler, AZ1,174$16,406,974664,839378
San Diego-Chula Vista-Carlsbad, CA699$13,304,455507,105386
Baltimore-Columbia-Towson, MD914$12,999,215471,428333
Atlanta-Sandy Springs-Roswell, GA1,020$12,641,778496,422335
Detroit-Warren-Dearborn, MI1,061$12,386,092476,768312
Miami-Fort Lauderdale-West Palm Beach, FL610$12,121,070480,420351
Seattle-Tacoma-Bellevue, WA1,225$12,106,952464,716250
Boston-Cambridge-Newton, MA-NH1,088$11,722,738415,229241
Dallas-Fort Worth-Arlington, TX812$9,916,579398,685325
San Francisco-Oakland-Fremont, CA580$7,872,053265,105256

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 2022.

Specialties billing 97530 nationally

Physical Therapist in Private Practice accounts for 84% of payment for 97530 nationally in 2022, across 17 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice47,37586%$624,546,32584%24,032,966507
Occupational Therapist in Private Practice6,62812%$108,071,00715%4,217,495636
Orthopedic Surgery3250.59%$2,096,9150.28%78,923243
Physical Medicine and Rehabilitation1160.21%$1,331,5470.18%47,694411
Speech Language Pathologist330.06%$596,1750.08%24,888754
Family Practice460.08%$592,3380.08%22,578491
Nurse Practitioner410.07%$495,8310.07%22,707554
Internal Medicine320.06%$400,0040.05%14,688459
Neurology260.05%$212,4520.03%8,160314
Hand Surgery390.07%$195,5100.03%7,318188
Interventional Pain Management140.03%$165,3020.02%6,887492
Optometry140.03%$150,1840.02%5,560397
Rheumatology180.03%$91,0430.01%3,150175
Otolaryngology180.03%$87,4080.01%3,396189
Physician Assistant120.02%$81,8630.01%3,489291

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 2022.

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