How much does Medicare pay for CPT 97018?

Medicare allowed an average of $4.04 per service and paid $3.13 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $31.89, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 97018?

Application of hot wax bath. It was billed 111,191 times to 21,109 Medicare beneficiaries by 758 providers in 2024.

Which specialty bills 97018 most?

Occupational Therapist in Private Practice, with 99,610 services from 652 clinicians. Next are Physical Therapist in Private Practice, Orthopedic Surgery, Podiatry.

CPT 97018

Application of hot wax bath

$4.04Medicare-allowed amount per service, averaged across 111,191 services

Providers submitted

$31.89

Asking price, not received

Medicare allowed

$4.04

The fee schedule figure

Medicare paid

$3.13

Balance is patient coinsurance

Providers submitted an average of $31.89 for this code and Medicare allowed $4.04 — 7.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $3.13 (77%); the rest is the patient’s coinsurance and deductible.

Services: 111,191
Beneficiaries: 21,109
Providers billing it: 758
Total allowed: $449,212

What Medicare pays for CPT 97018

Across 111,191 services billed by 758 providers to 21,109 beneficiaries, Medicare allowed an average of $4.04 per service. That is 5.3 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.

Who bills 97018

Specialty	Services	Beneficiaries	Avg allowed	Providers
Occupational Therapist in Private Practice	99,610	18,874	$4.04	652
Physical Therapist in Private Practice	9,113	1,575	$3.97	71
Orthopedic Surgery	1,025	401	$3.88	21
Podiatry	783	68	$4.35	3
Physical Medicine and Rehabilitation	337	95	$4.24	5
Hand Surgery	177	78	$3.63	5
General Practice	146	18	$3.99	1

97018 reimbursement by state

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.

State	Services	Allowed	Standardized pmt	Providers
California	41,597	$4.14	$2.99	187
New Jersey	8,742	$4.33	$3.07	58
New York	7,463	$4.53	$3.07	45
Maryland	5,284	$4.17	$3.03	41
Kentucky	4,867	$3.68	$3.07	22
Arizona	4,269	$3.77	$3.01	26
Massachusetts	3,236	$3.98	$3.00	12
Virginia	2,794	$3.83	$3.00	30
Texas	2,761	$3.85	$2.98	15
Pennsylvania	2,749	$3.79	$3.00	29
Louisiana	2,414	$3.66	$2.93	17
Colorado	2,408	$3.94	$2.93	20
Florida	2,209	$3.98	$2.97	19
Oregon	2,159	$3.93	$3.04	20
Washington	1,879	$3.99	$2.93	19
Nevada	1,582	$3.86	$3.06	19
Alabama	1,490	$3.43	$2.96	18
Georgia	1,362	$3.84	$2.96	19
Missouri	1,122	$3.77	$3.04	13
South Carolina	1,070	$3.71	$2.99	8
Idaho	1,062	$3.44	$2.71	6
Wyoming	1,005	$3.83	$2.97	4
Delaware	1,002	$3.91	$3.05	9
Tennessee	993	$3.58	$3.08	21
North Carolina	755	$3.63	$2.90	8
Mississippi	702	$3.59	$3.09	14
Connecticut	665	$4.32	$3.07	6
Michigan	604	$4.07	$2.99	7
Nebraska	479	$3.53	$2.94	3
New Hampshire	276	$3.91	$3.06	4
Kansas	257	$3.53	$2.99	2
Wisconsin	253	$3.58	$2.95	7
Rhode Island	232	$3.92	$3.02	2
Ohio	192	$3.73	$2.79	4
Indiana	169	$3.95	$3.05	2
New Mexico	131	$3.71	$3.10	2
Minnesota	114	$3.63	$3.08	3
Utah	113	$3.74	$2.92	2
Hawaii	110	$3.91	$2.90	2
Arkansas	96	$3.53	$2.83	1
Illinois	95	$4.32	$3.04	3
U.S. Virgin Islands	86	$3.61	$3.07	2
West Virginia	79	$3.68	$3.04	1
Montana	73	$3.92	$3.04	1
Iowa	69	$3.50	$2.79	2
Oklahoma	59	$3.21	$2.72	1
District of Columbia	39	$4.41	$3.05	1
Alaska	24	$4.90	$2.99	1

Related codes

97016Application of blood vessel compression device$8.54
97035Application of ultrasound$10.55
97032Application of electrical stimulation$11.47
97012Application of mechanical traction$10.73
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

Billing this code is not the same as earning it

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 →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.