How much does Medicare pay for CPT 97610?

Medicare allowed an average of $406.92 per service and paid $323.55 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1020.55, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 97610?

Therapy procedure using ultrasound. It was billed 157,146 times to 20,987 Medicare beneficiaries by 556 providers in 2024.

Which specialty bills 97610 most?

Nurse Practitioner, with 51,366 services from 201 clinicians. Next are Family Practice, Physician Assistant, Podiatry.

CPT 97610

Therapy procedure using ultrasound

$406.92Medicare-allowed amount per service, averaged across 157,146 services

Providers submitted

$1020.55

Asking price, not received

Medicare allowed

$406.92

The fee schedule figure

Medicare paid

$323.55

Balance is patient coinsurance

Providers submitted an average of $1020.55 for this code and Medicare allowed $406.92 — 2.5× 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 $323.55 (80%); the rest is the patient’s coinsurance and deductible.

Services: 157,146
Beneficiaries: 20,987
Providers billing it: 556
Total allowed: $63,945,850

What Medicare pays for CPT 97610

Across 157,146 services billed by 556 providers to 20,987 beneficiaries, Medicare allowed an average of $406.92 per service. That is 7.5 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 97610

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	51,366	7,584	$355.92	201
Family Practice	26,333	4,482	$431.42	112
Physician Assistant	13,842	1,084	$399.67	26
Podiatry	13,604	1,689	$431.21	72
Internal Medicine	11,943	1,254	$439.52	26
General Surgery	10,248	1,641	$429.61	40
Physical Therapist in Private Practice	7,357	636	$428.11	25
General Practice	6,246	844	$455.26	16
Geriatric Medicine	3,368	352	$484.74	2
Plastic and Reconstructive Surgery	2,693	242	$496.48	4
Undersea and Hyperbaric Medicine	1,289	213	$398.84	2
Nephrology	1,268	111	$414.10	2
Unknown Supplier/Provider Specialty	1,267	96	$457.61	1
Thoracic Surgery	1,103	70	$429.66	1
Emergency Medicine	1,023	94	$405.66	3

97610 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	31,114	$466.79	$322.14	67
Florida	20,997	$408.04	$324.21	88
New Jersey	17,872	$405.83	$288.99	39
Arizona	14,222	$362.93	$292.21	33
Texas	12,187	$389.62	$317.53	64
Oklahoma	8,162	$330.95	$295.94	28
Illinois	7,962	$408.21	$317.17	28
Nevada	6,335	$361.67	$287.07	12
Massachusetts	4,498	$467.94	$320.60	6
Pennsylvania	4,344	$417.89	$326.91	20
New York	3,310	$449.77	$317.85	17
Louisiana	2,644	$315.50	$282.47	26
Indiana	1,868	$381.53	$321.60	10
Kentucky	1,761	$373.06	$323.05	6
Missouri	1,674	$394.47	$332.95	4
Wisconsin	1,540	$408.92	$323.81	5
Maryland	1,429	$485.93	$334.83	7
Mississippi	1,405	$313.08	$289.76	11
Washington	1,389	$406.53	$297.31	6
Colorado	1,211	$436.65	$329.94	3
Kansas	1,119	$348.64	$305.39	6
Idaho	946	$338.04	$294.18	5
Oregon	922	$444.26	$331.91	3
North Carolina	908	$373.09	$317.53	8
Ohio	861	$383.08	$312.75	6
Connecticut	852	$430.32	$313.55	6
Utah	779	$379.61	$321.56	5
South Carolina	695	$397.14	$329.82	4
New Mexico	627	$421.59	$323.01	2
Arkansas	526	$308.09	$284.07	2
Alabama	489	$365.78	$330.72	3
Tennessee	464	$378.98	$318.16	5
Minnesota	454	$360.59	$316.59	5
Georgia	430	$375.13	$333.52	4
Nebraska	286	$385.15	$306.40	3
Virginia	252	$425.30	$313.11	2
West Virginia	210	$509.18	$334.84	1
Iowa	129	$389.29	$334.83	2
Northern Mariana Islands	102	$383.29	$334.83	1
Michigan	81	$429.02	$334.83	1
Hawaii	49	$388.84	$284.14	1
Rhode Island	41	$466.61	$334.84	1

Related codes

97605Therapy procedure$24.49
97607Therapy procedure$203.89
97606Therapy procedure$30.65

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.