How much does Medicare pay for CPT 97035?

Medicare allowed an average of $10.55 per service and paid $8.13 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $37.30, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 97035?

Application of ultrasound, each 15 minutes. It was billed 831,465 times to 128,899 Medicare beneficiaries by 4,432 providers in 2024.

Does 97035 pay differently in an office than a hospital?

Yes. The allowed amount averaged $10.55 in an office setting and $10.15 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 97035 most?

Physical Therapist in Private Practice, with 633,978 services from 3,332 clinicians. Next are Occupational Therapist in Private Practice, Internal Medicine, Physical Medicine and Rehabilitation.

CPT 97035

Application of ultrasound, each 15 minutes

$10.55Medicare-allowed amount per service, averaged across 831,465 services

Providers submitted

$37.30

Asking price, not received

Medicare allowed

$10.55

The fee schedule figure

Medicare paid

$8.13

Balance is patient coinsurance

Providers submitted an average of $37.30 for this code and Medicare allowed $10.55 — 3.5× 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 $8.13 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $10.55
Hospital / facility: $10.15

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 831,302 services were billed in an office setting and 163 in a facility.

Services: 831,465
Beneficiaries: 128,899
Providers billing it: 4,432
Total allowed: $8,771,956

What Medicare pays for CPT 97035

Across 831,465 services billed by 4,432 providers to 128,899 beneficiaries, Medicare allowed an average of $10.55 per service. That is 6.5 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 97035

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Therapist in Private Practice	633,978	96,377	$10.41	3,332
Occupational Therapist in Private Practice	94,378	19,259	$10.50	760
Internal Medicine	24,500	1,519	$11.73	28
Physical Medicine and Rehabilitation	20,693	2,489	$11.51	56
Podiatry	19,190	3,998	$12.24	104
Nurse Practitioner	9,199	1,411	$9.69	37
Family Practice	8,290	779	$11.21	25
General Practice	6,819	604	$11.92	12
Orthopedic Surgery	5,128	1,169	$10.63	39
Anesthesiology	2,976	241	$11.35	3
Pain Management	1,257	247	$11.35	6
Hand Surgery	1,118	229	$10.79	9
Neurology	638	134	$11.13	2
Interventional Pain Management	625	81	$10.18	2
Maxillofacial Surgery	601	24	$11.49	1

97035 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	148,422	$11.21	$8.17	526
New York	97,971	$11.55	$8.17	368
Florida	71,157	$10.24	$7.72	280
Pennsylvania	38,174	$10.13	$7.86	183
New Jersey	30,477	$11.22	$8.17	128
Illinois	29,667	$10.49	$7.98	166
Texas	23,174	$10.15	$7.93	123
Maryland	23,007	$10.65	$7.93	137
Louisiana	19,016	$9.99	$8.02	103
Arizona	18,475	$10.42	$8.12	79
Alabama	17,257	$9.53	$7.81	109
Nebraska	16,059	$9.61	$7.69	85
Arkansas	14,267	$9.65	$7.93	67
Georgia	13,573	$10.55	$8.28	88
Virginia	13,398	$10.34	$7.94	105
Michigan	13,134	$10.38	$8.03	91
North Carolina	13,107	$9.75	$7.62	104
South Carolina	12,249	$9.77	$7.74	67
Washington	12,237	$10.56	$7.86	68
Massachusetts	11,980	$10.99	$7.98	91
Tennessee	11,623	$9.56	$7.68	93
Utah	11,620	$10.12	$8.07	55
Missouri	10,504	$9.90	$7.91	71
Wyoming	10,084	$10.12	$7.83	80
Ohio	10,071	$9.76	$7.75	66
Puerto Rico	9,698	$10.08	$7.73	39
Colorado	8,857	$10.31	$7.85	79
Connecticut	8,245	$10.87	$8.06	46
Oklahoma	7,821	$9.76	$7.85	54
Minnesota	7,495	$10.23	$7.85	97
Kentucky	7,338	$9.90	$7.88	48
North Dakota	7,271	$10.42	$7.95	63
Kansas	7,104	$9.62	$7.83	58
Iowa	7,021	$9.64	$7.65	75
Indiana	6,352	$9.91	$7.79	75
Idaho	6,296	$9.73	$7.79	36
Oregon	6,123	$10.46	$8.07	40
Vermont	5,554	$10.20	$7.74	42
Wisconsin	5,166	$10.10	$7.93	62
South Dakota	5,092	$10.11	$7.82	46
Mississippi	4,498	$9.80	$8.02	34
New Hampshire	4,430	$10.33	$7.95	30
New Mexico	4,036	$10.17	$7.94	19
West Virginia	3,742	$9.66	$7.72	27
Rhode Island	3,260	$10.92	$8.10	20
Montana	3,011	$10.29	$7.92	28
Nevada	2,995	$10.40	$7.99	25
Delaware	2,566	$10.20	$7.88	17
District of Columbia	1,836	$12.82	$8.97	3
Maine	1,673	$9.98	$7.92	16
Hawaii	1,252	$10.15	$8.17	5
Alaska	1,150	$12.38	$7.92	13
XX	664	$10.64	$8.04	1
U.S. Virgin Islands	216	$10.47	$7.98	1

Related codes

97016Application of blood vessel compression device$8.54
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

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.