HCPCS 97530

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

Other services Work RVU per service 0.44 (2023 fee schedule)

62,717
100th percentile among 6,405 codes billed · 2023
$912M
100th percentile among 6,405 codes billed · 2023
36.1M
100th percentile among 6,405 codes billed · 2023
344
93rd percentile among 6,405 codes billed · 2023
1,827
91st percentile among 6,405 codes billed · 2023
+23.2%
Medicare payment on the code vs 2022; billers +14.4% · 2023

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
California5,199$99,938,0903,692,4533812,433
New York4,603$88,388,2923,052,6014172,066
New Jersey3,555$67,748,3922,385,5084691,902
Florida2,777$52,407,7132,206,1513692,838
Illinois3,316$47,119,4051,872,9513621,633
Pennsylvania2,481$39,166,2881,529,8284211,785
Texas2,724$38,853,8651,632,9773511,846
Maryland1,946$31,471,2281,170,4343981,860
Arizona1,816$30,180,5971,255,3534622,139
Virginia1,875$27,416,8291,081,1723431,704
Washington2,276$26,946,4401,081,2002931,458
South Carolina1,248$25,004,6481,090,8795982,557
Georgia1,833$24,154,9271,004,4753591,634
North Carolina1,963$22,293,801945,0312661,570
Michigan2,055$21,303,218864,7782801,194

Not listed: 14 billers with an armed-forces or unknown state code (AA, AE, AP, XX, 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ6,017$119,561,6334,066,328446
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD2,276$44,340,6901,657,177559
Chicago-Naperville-Elgin, IL-IN2,860$39,445,0451,532,673363
Los Angeles-Long Beach-Anaheim, CA1,728$33,050,4491,205,190352
Phoenix-Mesa-Chandler, AZ1,308$21,351,638882,172483
Washington-Arlington-Alexandria, DC-VA-MD-WV1,565$21,184,983762,910316
Miami-Fort Lauderdale-West Palm Beach, FL708$16,549,868688,901436
San Diego-Chula Vista-Carlsbad, CA794$16,538,511635,808432
Baltimore-Columbia-Towson, MD1,031$16,177,851610,372365
Seattle-Tacoma-Bellevue, WA1,377$15,267,714594,944283
Atlanta-Sandy Springs-Roswell, GA1,125$15,014,945609,925363
Boston-Cambridge-Newton, MA-NH1,257$14,948,522540,338286
Detroit-Warren-Dearborn, MI1,168$14,172,744564,652345
Dallas-Fort Worth-Arlington, TX1,013$13,240,069544,204343
San Francisco-Oakland-Fremont, CA594$9,313,349311,573335

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 97530 nationally

Physical Therapist in Private Practice accounts for 85% of payment for 97530 nationally in 2023, across 18 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice54,03086%$772,815,30185%30,459,084564
Occupational Therapist in Private Practice7,76112%$130,575,96714%5,284,976681
Physical Medicine and Rehabilitation1490.24%$2,182,6260.24%84,662568
Orthopedic Surgery3490.56%$2,146,6980.24%83,397239
Speech Language Pathologist470.07%$682,4730.07%29,271623
Family Practice470.07%$564,4720.06%23,129492
Internal Medicine300.05%$405,3010.04%15,909530
Nurse Practitioner390.06%$346,0440.04%15,955409
Neurology280.04%$226,8950.02%8,814315
Otolaryngology300.05%$165,7440.02%6,730224
Interventional Pain Management140.02%$163,9020.02%6,811487
Hand Surgery350.06%$157,0590.02%6,002171
Optometry170.03%$148,6830.02%5,465321
Rheumatology140.02%$98,0530.01%3,567255
Podiatry160.03%$63,165<0.01%2,234140

Not listed: 17 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 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