How much does Medicare pay for CPT 97750?

Medicare allowed an average of $28.71 per service and paid $22.04 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $91.27, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 97750?

Test or measurement for functional capacity, each 15 minutes. It was billed 308,234 times to 131,290 Medicare beneficiaries by 2,929 providers in 2024.

Does 97750 pay differently in an office than a hospital?

Yes. The allowed amount averaged $28.71 in an office setting and $29.20 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 97750 most?

Physical Therapist in Private Practice, with 137,471 services from 1,786 clinicians. Next are Podiatry, Orthopedic Surgery, Occupational Therapist in Private Practice.

CPT 97750

Test or measurement for functional capacity, each 15 minutes

$28.71Medicare-allowed amount per service, averaged across 308,234 services

Providers submitted

$91.27

Asking price, not received

Medicare allowed

$28.71

The fee schedule figure

Medicare paid

$22.04

Balance is patient coinsurance

Providers submitted an average of $91.27 for this code and Medicare allowed $28.71 — 3.2× 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 $22.04 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $28.71
Hospital / facility: $29.20

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 307,958 services were billed in an office setting and 276 in a facility.

Services: 308,234
Beneficiaries: 131,290
Providers billing it: 2,929
Total allowed: $8,849,398

What Medicare pays for CPT 97750

Across 308,234 services billed by 2,929 providers to 131,290 beneficiaries, Medicare allowed an average of $28.71 per service. That is 2.3 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 97750

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Therapist in Private Practice	137,471	58,225	$27.62	1,786
Podiatry	47,693	22,082	$32.29	204
Orthopedic Surgery	37,273	16,857	$29.53	151
Occupational Therapist in Private Practice	29,886	10,271	$26.79	395
Anesthesiology	9,257	2,040	$26.56	21
Physician Assistant	8,799	4,175	$25.12	71
Internal Medicine	7,058	2,798	$29.64	30
Nurse Practitioner	6,775	2,534	$26.42	55
Physical Medicine and Rehabilitation	4,315	1,638	$32.45	25
Pain Management	3,391	1,404	$29.61	17
Family Practice	3,254	1,466	$30.81	26
Neurology	3,056	2,534	$33.46	23
Urology	1,784	786	$33.03	15
Hand Surgery	1,190	906	$32.85	14
Sports Medicine	1,038	624	$30.24	10

97750 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	60,851	$32.13	$21.79	330
Florida	33,327	$27.53	$21.25	232
New York	20,066	$29.17	$21.54	179
New Jersey	19,172	$29.82	$21.75	272
Arizona	19,103	$27.22	$21.44	156
Texas	15,295	$27.56	$21.79	140
Michigan	14,389	$28.74	$22.17	82
Maryland	13,639	$29.21	$21.39	171
Pennsylvania	12,658	$27.57	$21.38	189
Virginia	10,663	$29.02	$21.06	124
North Carolina	10,220	$27.21	$21.00	101
Illinois	9,637	$27.82	$21.67	103
South Carolina	6,283	$25.14	$20.56	75
Ohio	6,060	$26.78	$22.06	84
Minnesota	4,864	$27.96	$21.46	59
Georgia	4,337	$27.66	$21.63	62
Massachusetts	4,243	$29.48	$21.87	34
Louisiana	3,923	$27.14	$22.45	24
Delaware	3,916	$27.51	$20.75	51
Alabama	3,855	$26.21	$21.22	33
Oklahoma	3,163	$24.32	$19.47	27
Colorado	2,803	$26.12	$19.44	46
Indiana	2,265	$25.95	$22.35	30
Kentucky	2,122	$26.22	$22.17	23
Missouri	1,728	$25.27	$20.60	15
Connecticut	1,662	$28.87	$21.36	24
Mississippi	1,552	$25.65	$21.63	11
Tennessee	1,475	$25.75	$20.92	28
Arkansas	1,425	$26.29	$22.56	28
Washington	1,374	$29.30	$21.80	21
Utah	1,260	$28.19	$18.44	14
Oregon	1,212	$26.91	$19.74	11
Nevada	1,054	$27.59	$21.10	12
Nebraska	972	$25.19	$20.28	11
Maine	838	$25.72	$19.82	11
Wisconsin	807	$26.39	$20.33	18
Hawaii	749	$26.43	$19.66	7
New Mexico	651	$29.31	$21.96	9
Wyoming	643	$28.90	$22.55	12
New Hampshire	619	$29.20	$22.45	9
Kansas	603	$26.37	$20.89	11
District of Columbia	428	$30.21	$21.28	10
Idaho	424	$25.32	$19.36	4
South Dakota	373	$29.20	$22.00	7
Montana	337	$28.18	$21.49	4
Iowa	285	$25.55	$21.22	8
Vermont	232	$30.15	$23.77	3
North Dakota	227	$27.63	$20.64	5
Rhode Island	185	$30.57	$23.11	3
Alaska	144	$33.73	$20.20	1
West Virginia	83	$28.63	$22.28	4
AE	38	$27.01	$19.48	1

Related codes

97760Training in the use of orthopedic device for arm$40.00
97763Follow-up training in the use of orthopedic device or artificial arm$45.92
97761Training in the use of artificial arm and/or leg$35.70
97755Evaluation for assistive technology$30.38

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.