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 97760 Fee Schedule
Last Verified: September 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.
Orthotic(S) Management And Training (Including Assessment And Fitting When Not Otherwise Reported) Upper Extremity(Ies) Lower Extremity(Ies) And/Or Trunk Initial Orthotic Encounter Each 15 Minutes (Desc Revised 1/1/2018)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | None GO - Services delivered under an outpatient occupational therapy plan of care GP - Services delivered under an outpatient physical therapy plan of care |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 97760 |
| Medicaid Fee Schedule | View Medicaid rates for 97760 |
National average reimbursement for CPT 97760 by major payers:
$56.45
$44.08
$39.30
$54.31
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 97760.
CPT 97760
5 of 25 sample ratesHigher to lower in this preview
Ian Cote
University Of Miami
$98.59Published rateAshley Mosseri
Lakeland Regional Health Systems Inc
$36.59Published rateFederico Auger
$34.36Published rateBrian Frenchman
Palm Beach Family Foot Care PA
$30.79Published rateFoot & Ankle Associates Of West Florida PA
Foot & Ankle Associates Of West Florida, P.A.
$21.35Published 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 97760 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97760 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 97760 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 |
|---|---|---|
| 97545-CPT | Low | Work Hardening/Condit Initial 2 Hrs |
| 97546-CPT | Low | Work Hardeningconditioning E, Work Hardeningconditioning Each Additional Hour (Listseparately In Addition To Code For Primary Procedure) Work Hardeningconditioning Each Additional Hour (List |
| 97750-CPT | Low | Physical Performance Test, Physical Performance Test Or Measurement Eg Musculoskeletal Functional Capacity With Written Report Each 15 Minutes |
| 97760-CPT | Low | Orthotic(S) Management And Training (Including Assessment And Fitting When Not Otherwise Reported) Upper Extremity(Ies) Lower Extremity(Ies) And/Or Trunk Initial Orthotic Encounter Each 15 Minutes (Desc Revised 1/1/2018) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97760. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97760 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 97760) and we'll show you how you compare in 15 minutes or less.