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See a sample rate comparisonCPT 97814 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.
Acupunct W Stimul Addl 15m, Acupuncture 1 Or More Needles With Electrical Stimulation Each Additional 15 Minutes Of Personal One On One Contact With The Patient With Re Insertion Of Needle S List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Acupuncture Procedures |
| Common Place of Service | 11 - Office 49 - Independent Clinic |
| Common Modifiers | 59 - Distinct Procedural Service 79 - Unrelated procedure - postop period |
| Complexity Level | Low |
| Medicare Fee Schedule | $28.73 national non-facility rate (2026) · View Medicare rates for 97814 |
| Medicaid Fee Schedule | $22.325 median of the 6 states in the free preview · View Medicaid rates for 97814 |
National average reimbursement for CPT 97814 by major payers:
$39.35
$41.76
$42.12
$59.81
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CPT 97814
5 of 25 sample ratesHigher to lower in this preview
Adam Rappoport
The Nemours Foundation
$116.72Published rateAlba Pergjika
$68.30Published rateMarla Hartzen
Advocate Health And Hospitals Corporation
$60.00Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$38.25Published rateNidhi Mehta
Town Center Orthopaedic Associates, P.C.
$26.07Published rate
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See a sample payer proposalCPT 97814 vs. Other Acupuncture Procedures Codes
The CPT 97814 code is part of the Medicine Services and Procedures services used for Acupuncture Procedures. 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 97814 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 |
|---|---|---|
| 97810-CPT | Low | Acupunct W O Stimul 15 Min, Acupuncture 1 Or More Needles Without Electrical Stimulation Initial 15 Minutes Of Personal One On One Contact With The Patient |
| 97811-CPT | Low | Acupunct W O Stimul Addl 15m, Acupuncture 1 Or More Needles Without Electrical Stimulation Each Additional 15 Minutes Of Personal One On One Contact With The Patient With Re Insertion Of Needle S List Separately In Addition To Code For Primary Procedure |
| 97813-CPT | Low | Acupuncture With Stimulation, Acupuncture Services Provided In 15-Minute Increments. Includes Electrical Stimulation Of The Acupuncture Points After Needles Are Inserted. |
| 97814-CPT | Low | Acupunct W Stimul Addl 15m, Acupuncture 1 Or More Needles With Electrical Stimulation Each Additional 15 Minutes Of Personal One On One Contact With The Patient With Re Insertion Of Needle S List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97814. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97814 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
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit numeric codes used by healthcare providers to report medical, surgical, and diagnostic services and procedures to entities like physicians, health insurance companies, and accreditation organizations. They are essential for accurate billing and for tracking healthcare statistics.
Finding the exact cost of a medical procedure can be complex due to factors like insurance coverage, location, provider fees, and specific medical needs. For estimated costs based on CPT codes and your specific location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your location to get relevant pricing information. It's always advisable to also contact your insurance provider and the healthcare facility directly for the most accurate out-of-pocket estimates.
A fee schedule is a complete listing of fees used by health plans to pay physicians or other providers. It specifies the maximum dollar amount that the plan will reimburse for each service, procedure, or supply. These schedules are often based on CPT codes and can vary significantly by payer, region, and type of service.
Medical costs vary widely due to several factors including geographic location (cost of living and labor), the specific healthcare provider or facility (e.g., hospital vs. independent clinic), negotiated rates with different insurance companies, the complexity of the procedure, and whether the patient is in-network or out-of-network. Transparency tools like Payerprice can help patients understand these varying costs by providing localized fee schedules.
To look up specific medical procedure prices for your location, especially by CPT code, it's recommended to use a specialized tool like Payerprice. Payerprice provides a fee schedule lookup tool where you can enter a CPT code and your specific location to find relevant pricing information. This can offer a more tailored estimate than general public databases.
Payerprice is a service that provides a fee schedule lookup tool. Users can search with CPT codes and specific locations to find pricing information for medical procedures. It aims to offer transparency into healthcare costs, helping patients and providers understand potential charges and reimbursements across various payers.
Payerprice provides a fee schedule lookup tool for users to search with CPT codes and specific locations, offering granular pricing data that can be relevant to individual situations and various payers. CMS (Centers for Medicare & Medicaid Services), on the other hand, is a federal agency that administers Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). While CMS publishes extensive fee schedules for its programs (like the Medicare Physician Fee Schedule), these rates are specific to government programs and may not reflect prices for private insurance or the general market. Payerprice is designed to provide broader market-relevant fee schedule information across various payers and locations, whereas CMS data is specific to its beneficiaries and programs.