How much does Medicare pay for CPT 97124?

Medicare allowed an average of $25.23 per service and paid $19.57 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $59.94, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 97124?

Therapy procedure using massage, each 15 minutes. It was billed 296,189 times to 32,652 Medicare beneficiaries by 755 providers in 2024.

Does 97124 pay differently in an office than a hospital?

Yes. The allowed amount averaged $25.23 in an office setting and $25.90 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 97124 most?

Physical Therapist in Private Practice, with 217,507 services from 568 clinicians. Next are Occupational Therapist in Private Practice, Physical Medicine and Rehabilitation, Family Practice.

CPT 97124

Therapy procedure using massage, each 15 minutes

$25.23Medicare-allowed amount per service, averaged across 296,189 services

Providers submitted

$59.94

Asking price, not received

Medicare allowed

$25.23

The fee schedule figure

Medicare paid

$19.57

Balance is patient coinsurance

Providers submitted an average of $59.94 for this code and Medicare allowed $25.23 — 2.4× 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 $19.57 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $25.23
Hospital / facility: $25.90

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 296,077 services were billed in an office setting and 112 in a facility.

Services: 296,189
Beneficiaries: 32,652
Providers billing it: 755
Total allowed: $7,472,848

What Medicare pays for CPT 97124

Across 296,189 services billed by 755 providers to 32,652 beneficiaries, Medicare allowed an average of $25.23 per service. That is 9.1 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 97124

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Therapist in Private Practice	217,507	25,599	$24.74	568
Occupational Therapist in Private Practice	24,659	2,367	$26.08	70
Physical Medicine and Rehabilitation	12,277	1,024	$27.49	26
Family Practice	8,481	800	$28.06	17
Anesthesiology	8,029	286	$27.09	3
Internal Medicine	6,225	644	$26.23	18
Nurse Practitioner	3,961	335	$20.13	11
General Practice	3,378	344	$29.11	9
Interventional Pain Management	2,868	129	$22.25	3
Orthopedic Surgery	1,908	204	$28.73	8
Pain Management	1,867	153	$30.58	4
Podiatry	1,656	510	$28.00	8
Neurology	1,274	117	$29.30	4
Allergy/ Immunology	1,064	24	$28.56	1
Preventive Medicine	450	33	$22.80	1

97124 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
New York	88,440	$26.42	$18.50	192
California	63,479	$26.11	$18.36	141
Florida	26,303	$20.93	$15.80	52
New Jersey	23,076	$27.79	$19.27	56
Maryland	13,875	$23.80	$17.35	37
Puerto Rico	8,904	$26.06	$21.07	38
Alabama	6,839	$25.31	$21.41	11
Pennsylvania	5,526	$23.96	$18.76	18
Texas	5,034	$21.84	$17.60	24
Tennessee	5,032	$20.91	$16.83	16
Nevada	4,999	$23.16	$21.29	7
Michigan	4,487	$23.26	$18.31	13
Massachusetts	4,328	$28.23	$19.59	14
South Carolina	3,760	$21.86	$19.14	11
Georgia	3,440	$23.24	$19.01	9
Alaska	2,915	$27.25	$17.38	3
Virginia	2,697	$26.63	$19.42	9
Illinois	2,319	$24.60	$18.53	10
Indiana	2,289	$24.40	$20.20	6
Arkansas	2,128	$24.76	$20.96	12
North Carolina	1,954	$20.12	$16.18	7
West Virginia	1,761	$23.42	$18.78	9
Kansas	1,757	$23.89	$19.35	2
Missouri	1,271	$22.55	$17.89	3
Louisiana	1,134	$22.55	$19.84	7
Colorado	1,004	$26.84	$18.84	3
Delaware	881	$24.22	$18.41	6
Utah	785	$20.84	$18.33	7
Oregon	707	$22.59	$17.22	2
Washington	666	$24.11	$18.08	6
Nebraska	652	$26.54	$22.40	3
Minnesota	623	$24.99	$17.10	1
District of Columbia	472	$27.29	$19.28	3
Arizona	428	$24.82	$19.50	3
Mississippi	409	$25.93	$22.52	1
Connecticut	397	$25.00	$17.72	3
New Mexico	374	$24.08	$18.71	2
Vermont	282	$21.14	$16.24	1
Hawaii	174	$27.87	$19.95	1
Kentucky	167	$22.62	$17.99	1
Wisconsin	158	$24.26	$18.96	1
Ohio	146	$24.15	$19.89	1
Iowa	57	$25.84	$21.27	1
Montana	35	$28.38	$22.62	1
Idaho	25	$23.27	$12.03	1

Related codes

97110Therapy procedure$22.78
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function$27.06
97140Therapy procedure$20.62
97116Therapy procedure for walking training$21.87
97150Therapy procedure in a group setting$13.60
97161Evaluation for physical therapy$99.49
97162Evaluation for physical therapy$99.21
97113Therapy procedure$27.67
97130Therapy procedure for a range of mental processes$21.18
97164Re-evaluation for physical therapy$68.54
97129Therapy procedure for a range of mental processes$21.82
97163Evaluation for physical therapy$99.08

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.