Top billers · Codes · 97530

Who bills 97530?

97530 is the CPT code for: Therapy procedure using functional activities. In 2024, 70,092 providers billed 97530 43,562,919 times, with an estimated $1.1B paid by Medicare.

$35.07
2026 PFS national rate (office)
70,092
Providers billing it (2024)
43,562,919
Services billed
$1.1B
Est. Medicare paid
The fee

What does Medicare pay for 97530?

Medicare's 2026 Physician Fee Schedule national rate for 97530 is $35.07 in the office setting. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$35.07
Facility rateNo separate facility rate
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $24.41 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 97530 the most.

The top 5 billers nationally, ranked by 2024 Medicare service volume.

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Patricia Freire, PTPhysical Therapist in Private PracticeSw Ranches, FL28,814$540K
2Matthew Fiano, PT, DPTPhysical Therapist in Private PracticeVirginia Beach, VA25,318$556K
3Kari Reid, OTROccupational Therapist in Private PracticeTampa, FL22,230$423K
4Pedro Machin, OTROccupational Therapist in Private PracticeMiami, FL21,905$480K
5Adi HaliliPhysical Therapist in Private PracticeTucson, AZ21,080$429K

70,087 more providers billed 97530 in 2024. The full ranked list — filtered to your exact territory, with phone numbers and year-over-year history — is one search in Prospect 811.

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The breakdown

Where 97530 gets billed.

Top states by volume

California4,474,491 services
New York3,679,986 services
New Jersey2,854,230 services
Florida2,848,046 services
Illinois2,133,050 services
Texas2,091,173 services
Pennsylvania1,900,186 services
Arizona1,549,395 services

About this code

CMS descriptionTherapy procedure using functional activities
Code typeCPT (Level I HCPCS)
Providers billing it (2024)70,092
Services billed (2024)43,562,919
Avg. Medicare payment per service (2024)$24.41
Where these numbers come from. Rates are CMS's own public fee-schedule files — the Physician Fee Schedule, Clinical Laboratory Fee Schedule, ASP drug pricing, DMEPOS, and the OPPS/ASC addenda — each labeled with its file year on this page; national amounts are shown before geographic adjustment. Codes with no separate rate render the fee schedule's own status in words, never a fake $0. Utilization comes from CMS's public Medicare Provider Utilization & Payment data for 2024, the most recent year released. It covers traditional Medicare fee-for-service only (no commercial insurance, no Medicare Advantage), and CMS suppresses any provider-and-code line with fewer than 11 beneficiaries before publishing, so low-volume billers don't appear at all. "Est. Medicare paid" is each billing line's average Medicare payment times its service count, summed — actual per-claim payment varies by setting and modifiers. For drug and supply codes, a "service" is a billed unit (a milligram, a milliliter, a square centimeter), not a patient visit. Code descriptions are CMS's own, from the utilization files. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

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