CPT 97016

Across 838,466 services billed by 4,548 providers to 141,833 beneficiaries, Medicare allowed an average of $8.54 per service. That is 5.9 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

• 97035Application of ultrasound$10.55
• 97032Application of electrical stimulation$11.47
• 97012Application of mechanical traction$10.73
• 97018Application of hot wax bath$4.04
• 97022Application of whirlpool therapy$11.83
• 97026Application of low energy heat$4.88
• 97033Application of medication$13.40
• 97024Application of heat wave therapy$4.77
• 97028Application of ultraviolet light$6.47
• 97034Application of hot and cold baths$10.76

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →