97161 is the CPT code for: Evaluation for physical therapy, typically 20 minutes. In 2024, 37,020 providers billed 97161 1,576,730 times, with an estimated $114.9M paid by Medicare.
Medicare's 2026 Physician Fee Schedule national rate for 97161 is $97.86 in the office setting. National amounts before geographic adjustment — your locality's rate differs slightly.
What Medicare actually paid per service in 2024, on average: $72.88 (observed payment across all settings and modifiers — not a fee-schedule rate).
The top 5 billers nationally, ranked by 2024 Medicare service volume.
| # | Provider | Specialty | Location | Services | Est. Medicare paid |
|---|---|---|---|---|---|
| 1 | Ryan Urenda, PT | Physical Therapist in Private Practice | Jupiter, FL | 1,487 | $109K |
| 2 | Simon Tan, MD | Neurology | Southlake, TX | 1,086 | $82K |
| 3 | Patricia Freire, PT | Physical Therapist in Private Practice | Sw Ranches, FL | 1,015 | $66K |
| 4 | Ken Richards, PT | Physical Therapist in Private Practice | Ventura, CA | 918 | $76K |
| 5 | Robin Pflieger, PT, DPT | Physical Therapist in Private Practice | Neptune, NJ | 560 | $46K |
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