How much does Medicare pay for CPT 97533?

Medicare allowed an average of $52.00 per service and paid $40.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $93.61, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 97533?

Therapy procedure using sensory experiences. It was billed 93,540 times to 5,894 Medicare beneficiaries by 195 providers in 2024.

Which specialty bills 97533 most?

Physical Therapist in Private Practice, with 33,924 services from 84 clinicians. Next are Occupational Therapist in Private Practice, Nurse Practitioner, Audiologist.

CPT 97533

Therapy procedure using sensory experiences

$52.00Medicare-allowed amount per service, averaged across 93,540 services

Providers submitted

$93.61

Asking price, not received

Medicare allowed

$52.00

The fee schedule figure

Medicare paid

$40.81

Balance is patient coinsurance

Providers submitted an average of $93.61 for this code and Medicare allowed $52.00 — 1.8× 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 $40.81 (78%); the rest is the patient’s coinsurance and deductible.

Services: 93,540
Beneficiaries: 5,894
Providers billing it: 195
Total allowed: $4,864,080

What Medicare pays for CPT 97533

Across 93,540 services billed by 195 providers to 5,894 beneficiaries, Medicare allowed an average of $52.00 per service. That is 15.9 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.

Who bills 97533

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Therapist in Private Practice	33,924	2,904	$54.51	84
Occupational Therapist in Private Practice	33,618	1,087	$45.38	45
Nurse Practitioner	14,975	1,049	$59.68	44
Audiologist	4,906	391	$52.88	2
Physician Assistant	1,579	159	$63.73	8
Speech Language Pathologist	1,235	64	$46.36	2
Neuropsychiatry	860	60	$63.03	2
Physical Medicine and Rehabilitation	806	22	$49.46	1
Optometry	679	43	$45.29	3
Psychiatry	444	24	$53.80	1
Family Practice	388	24	$54.35	2
Otolaryngology	126	67	$65.73	1

97533 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	45,713	$56.05	$42.13	92
Florida	20,373	$43.46	$35.44	13
Georgia	5,247	$52.29	$41.71	17
New York	4,967	$51.08	$43.10	17
Texas	3,679	$48.45	$38.47	8
Arizona	3,163	$51.90	$40.32	5
New Jersey	1,916	$59.53	$44.12	4
Illinois	1,561	$48.34	$37.01	3
Virginia	1,128	$51.71	$43.02	3
Colorado	938	$55.68	$43.45	7
Puerto Rico	787	$36.40	$39.75	1
Vermont	723	$54.01	$44.44	7
Nevada	681	$53.63	$45.13	3
Maryland	535	$55.12	$41.03	1
North Carolina	512	$55.02	$42.25	3
Pennsylvania	356	$39.36	$34.46	1
Louisiana	353	$55.59	$44.66	2
Washington	238	$53.92	$44.36	1
Michigan	178	$51.31	$48.80	1
Alaska	172	$55.09	$28.60	1
South Carolina	107	$50.00	$41.49	1
Massachusetts	96	$69.79	$48.80	1
District of Columbia	64	$53.87	$44.30	1
Oregon	34	$58.39	$42.13	1
Ohio	19	$49.33	$48.80	1

Related codes

97530Therapy procedure$31.54
97535Training for self-care or home management$25.35
97597Removal of tissue from wound$74.53
97598Removal of tissue from wound$33.10
97542Evaluation for wheelchair$23.83
97550Caregiver training in strategies and techniques to facilitate the pati$51.87
97537Training for community or work reintegration$24.91

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.