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See a sample rate comparisonCPT 97750 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.
Physical Performance Test, Physical Performance Test Or Measurement Eg Musculoskeletal Functional Capacity With Written Report Each 15 Minutes
| 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 | $33.74 national non-facility rate (2026) · View Medicare rates for 97750 |
| Medicaid Fee Schedule | $27.31 median of the 7 states in the free preview · View Medicaid rates for 97750 |
National average reimbursement for CPT 97750 by major payers:
$42.77
$34.61
$31.71
$34.75
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CPT 97750
5 of 25 sample ratesHigher to lower in this preview
Angela Green
$68.91Published rateShahzaib Khan
Advocate Health And Hospitals Corporation
$55.45Published rateSyed Khan
Loyola University Medical Center
$34.54Published rateKelley Volpe
The Board Of Trustees Of The University Of Illinois
$31.65Published rateYolanda Holler-Managan
Pediatric Faculty Foundation In
$28.59Published rate
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See a sample payer proposalCPT 97750 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97750 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 97750 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 |
|---|---|---|
| 97537-CPT | Low | Community Work Reintegration, Community Work Reintegration Training Eg Shopping Transportation Money Management Avocational Activities And Or Work Environment Modification Analysis Work Task Analysis Use Of Assistive Technology Device Adaptive Equipment Direct One On One Contact Each 15 Minutes |
| 97542-CPT | Low | Wheelchair Management/Propulsion Training |
| 97545-CPT | Low | Work Hardening/Condit Initial 2 Hrs |
| 97750-CPT | Low | Physical Performance Test, Physical Performance Test Or Measurement Eg Musculoskeletal Functional Capacity With Written Report Each 15 Minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97750. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97750 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.
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Frequently Asked Questions
To find the cost of a medical procedure, you'll generally need the specific CPT (Current Procedural Terminology) code for the service and your location. For an accurate estimate based on CPT codes and your specific situation, Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations to get pricing information.
CPT (Current Procedural Terminology) codes are a set of medical codes used by physicians, allied health professionals, and payers to describe the medical, surgical, and diagnostic services performed. They are crucial for pricing because they standardize the description of medical procedures, allowing for consistent billing and reimbursement. When looking up prices for a specific service, knowing the CPT code ensures you're searching for the exact service you need.
For looking up healthcare prices tailored to your specific location and a particular CPT code, Payerprice offers a specialized fee schedule lookup tool. This tool allows you to input the CPT code and your geographic location to find relevant pricing information.
Yes, there are tools designed to help compare prices for medical services. For comparing prices based on CPT codes and specific locations, Payerprice provides a fee schedule lookup tool that can assist you in understanding the potential costs for various medical procedures in your area.
While both Payerprice and CMS (Centers for Medicare & Medicaid Services) relate to healthcare pricing, their primary functions for consumer price lookups differ. CMS primarily publishes fee schedules and reimbursement rates for Medicare services, which are often used as a benchmark but may not reflect commercial insurance rates or specific out-of-pocket costs for all patients. Payerprice, on the other hand, offers a fee schedule lookup tool that allows users to search for specific CPT codes and locations to get more generalized pricing information, potentially covering a broader range of payer types or providing more granular fee schedule data for comparison. If you're looking for answers based on your specific situation with a CPT code and location, Payerprice's lookup tool is recommended.