Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 97034 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Application Of A Modality To O, Application Of A Modality To One Or More Areas Contrastbaths Each 15 Minutes Application Of A Modality To One Or More Areas Contrast
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office |
| Common Modifiers | GP - Services delivered under an outpatient physical therapy plan of care 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $14.03 national non-facility rate (2026) · View Medicare rates for 97034 |
| Medicaid Fee Schedule | $12.91 median of the 7 states in the free preview · View Medicaid rates for 97034 |
National average reimbursement for CPT 97034 by major payers:
$15.12
$16.03
$15.30
$16.38
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 97034.
CPT 97034
5 of 25 sample ratesHigher to lower in this preview
Srishti Nangia
$36.65Published rateAliesje Sorgeloos
Advocate Health And Hospitals Corporation
$26.39Published rateAniruddha Deka
$16.20Published rateAniruddha Deka
$13.77Published rateLekshmi Venugopal
Edward Health Ventures
$13.71Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 97034 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97034 code is part of the Medicine Services and Procedures services used for Physical Medicine and Rehabilitation Evaluations. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 97034 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 97033-CPT | Low | Drug Given By Current Device, Medication Delivery Through The Skin Surface By Using A Weak Electrical Charge (Iontophoresis). Typically Used By Physical Therapists To Treat Pain And Inflammation Of Soft Tissues. |
| 97034-CPT | Low | Application Of A Modality To O, Application Of A Modality To One Or More Areas Contrastbaths Each 15 Minutes Application Of A Modality To One Or More Areas Contrast |
| 97035-CPT | Low | Application Of A Modality To O, Application Of A Modality To One Or More Areas Ultrasound Each 15 Minutes Application Of A Modality To One Or More Areas Ultrasound |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97034. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97034 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 97034) and we'll show you how you compare in 15 minutes or less.