CPT code 97016: Vasopneumatic therapy, supervised, untimed compression modality2026 Medicare rate & RVUs in Rhode Island

Report supervised vasopneumatic compression therapy for swelling after injury or surgery, or for lymphedema, when a device applies cyclic pressure.

CMS RVU26DEffective Oct 1, 2026One payment locality988.7K Medicare services in 2024

In Rhode Island, Medicare pays $12.29 for 97016 in the office.

$12.29Office (non-facility)
Not available in this settingHospital or facility
+2.2%vs the national office rate ($12.02)

Check a contract rate as a % of Medicare · 97016 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 97016 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Rhode Island
  2. What 97016 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 97016 covers

A vasopneumatic device inflates and deflates a sleeve, boot, or wrap around a limb or joint to apply cyclic pressure to swollen tissue. Some devices also circulate cold fluid. Physical and occupational therapists, and assistants working under them, use the treatment in outpatient rehabilitation for postoperative knee swelling, ankle sprains, or arm or leg lymphedema. The clinician sets up and supervises the modality but need not remain one-on-one throughout the treatment.

Report one untimed unit per date of service, even if the device treats more than one area or runs for a longer period. The record should identify the treated area, duration, relevant device settings when available, the swelling and its functional effects, and the patient's response under the therapy plan of care. Objective measurements can help demonstrate progress but are not required at every session. A professional component modifier is not used for this therapy service. When multiple therapy units are furnished on the same day, Medicare reduces practice expense payment for the second and later units.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Rhode Island compares for 97016

Across 109 of 109 payment localities, the office rate for 97016 runs from $11.06 in Arkansas to $15.25 in Alaska. Rhode Island pays $12.29. The RVUs are the same everywhere; the geographic indexes change the dollars.

97016 in Rhode Island vs other payment areas
  1. Rhode Island · this page$12.29
  2. Los Angeles, CA · California$13.20+$0.91
  3. Washington, DC area · District of Columbia$13.40+$1.11
  4. Miami, FL · Florida$12.77+$0.48
  5. Chicago, IL · Illinois$12.53+$0.24
  6. Manhattan, NY · New York$13.52+$1.23
  7. Alaska · Alaska$15.25+$2.96

Other areas in Rhode Island first, then benchmark localities. Bars start at $0.

Every other payment area

97016 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$11.17—
ArkansasArkansas$11.06—
ArizonaArizona$11.80—
Bakersfield, CACalifornia$12.55—
Chico, CACalifornia$12.52—
El Centro, CACalifornia$12.52—
Fresno, CACalifornia$12.52—
Hanford, CACalifornia$12.52—

97016 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$11.06

$15.25

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
97016 office rate range by state
State / territoryOffice rate rangeLocalities
AK$15.251
AL$11.171
AR$11.061
AZ$11.801
CA$12.52–$15.0429
CO$12.391
CT$12.651
DC$13.401
DE$11.951
FL$11.94–$12.773
GA$11.48–$12.202
GU$12.661
HI$12.661
IA$11.341
ID$11.391
IL$11.72–$12.534
IN$11.441
KS$11.311
KY$11.371
LA$11.36–$11.732
MA$12.35–$13.342
MD$12.13–$13.403
ME$11.44–$11.852
MI$11.57–$12.052
MN$11.951
MO$11.23–$11.753
MS$11.151
MT$12.021
NC$11.521
ND$11.831
NE$11.381
NH$12.221
NJ$12.82–$13.332
NM$11.621
NV$11.971
NY$11.64–$13.775
OH$11.531
OK$11.341
OR$11.90–$12.672
PA$11.54–$12.432
PR$12.081
RI$12.291
SC$11.541
SD$11.801
TN$11.351
TX$11.49–$12.338
UT$11.651
VA$11.83–$13.402
VI$12.081
VT$11.801
WA$12.32–$13.552
WI$11.551
WV$11.421
WY$11.941

See 97016 in every payment locality

How the 97016 rate is calculated

Each of 97016’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 97016

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.18

0.18 RVUs× 1.000 GPCI

Practice expense0.17

0.17 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.3600

Conversion factor

$33.4009

Medicare rate

$12.02

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Rhode Island inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,846

Code
97016
Physician work
0.18
Practice expense
0.17
Malpractice
0.01

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for 97016 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0190.1834
Practice expense0.17× 1.0330.1756
Malpractice0.01× 0.8920.0089
Total RVUs0.3679
Conversion factor× 33.4009

Office rate, Rhode Island$12.29

Office: (0.18 × 1.019 + 0.17 × 1.033 + 0.01 × 0.892) × $33.4009 = $12.29

Open 97016 in the RVU calculator

Payment rules and modifiers for 97016

The CMS indicators that decide how 97016 is paid alongside other services.

CMS payment indicators · 97016

Vasopneumatic therapy, supervised, untimed compression modality

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures5Therapy reduction: practice expense of the second and later units is reduced.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

97016 without CQ · national office

$12.02

Vasopneumatic therapy, supervised, untimed compression modality

97016-CQ · Allowed amount unchanged

$12.02

Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.

How 97016 has changed in Rhode Island

97016 · Office / nonfacility

$12.29

Effective 2026-10-01

The base rate is $0.33 higher than on 2025-10-01, moving from $11.96 to $12.29 (2.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $11.96changed to$12.29

    • Conversion factor 32.3465 changed to 33.4009
    • Work GPCI 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $11.96changed to$11.96

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.16 changed to 0.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $11.76changed to$11.96

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $12.21changed to$11.76

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849
  5. January 1, 2023

    RVU23A

    $12.50changed to$12.21

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $12.61changed to$12.50

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $13.07changed to$12.61

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $13.46changed to$13.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.17 changed to 0.16
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.050 changed to 1.049
    • Malpractice GPCI 0.999 changed to 0.990

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $16.84changed to$13.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.26 changed to 0.17

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $20.53changed to$16.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.36 changed to 0.26
    • Work GPCI 1.025 changed to 1.027
    • Practice expense GPCI 1.052 changed to 1.050
    • Malpractice GPCI 0.879 changed to 0.999

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $20.05changed to$20.53

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.35 changed to 0.36
    • Work GPCI 1.022 changed to 1.025
    • Practice expense GPCI 1.053 changed to 1.052
    • Malpractice GPCI 0.759 changed to 0.879

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $20.13changed to$20.05

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $20.03changed to$20.13

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $20.13changed to$20.03

    • Conversion factor 35.8228 changed to 35.7547
    • Work GPCI 1.020 changed to 1.022
    • Malpractice GPCI 0.973 changed to 0.759

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$20.13

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$12.29Not available in this settingRVU26D
2026-07-01$12.29Not available in this settingRVU26C
2026-04-01$12.29Not available in this settingRVU26B
2026-01-01$12.29Not available in this settingRVU26A
2025-10-01$11.96Not available in this settingRVU25D
2025-07-01$11.96Not available in this settingRVU25C
2025-04-01$11.96Not available in this settingRVU25B
2025-01-01$11.96Not available in this settingRVU25A
2024-10-01$11.96Not available in this settingRVU24D
2024-07-01$11.96Not available in this settingRVU24C
2024-04-01$11.96Not available in this settingRVU24B
2024-03-09$11.96Not available in this settingRVU24AR
2024-01-01$11.76Not available in this settingRVU24A
2023-10-01$12.21Not available in this settingRVU23D
2023-07-01$12.21Not available in this settingRVU23C
2023-04-01$12.21Not available in this settingRVU23B
2023-01-01$12.21Not available in this settingRVU23A
2022-10-01$12.50Not available in this settingRVU22D
2022-07-01$12.50Not available in this settingRVU22C
2022-04-01$12.50Not available in this settingRVU22B
2022-01-01$12.50Not available in this settingRVU22A
2021-10-01$12.61Not available in this settingRVU21D
2021-07-01$12.61Not available in this settingRVU21C
2021-04-01$12.61Not available in this settingRVU21B
2021-01-01$12.61Not available in this settingRVU21A
2020-10-01$13.07Not available in this settingRVU20D
2020-07-01$13.07Not available in this settingRVU20C
2020-04-01$13.07Not available in this settingRVU20B
2020-01-01$13.07Not available in this settingRVU20A
2019-10-01$13.46Not available in this settingRVU19D
2019-07-01$13.46Not available in this settingRVU19C
2019-04-01$13.46Not available in this settingRVU19B
2019-01-01$13.46Not available in this settingRVU19A
2018-10-01$16.84Not available in this settingRVU18D
2018-07-01$16.84Not available in this settingRVU18C
2018-04-01$16.84Not available in this settingRVU18B
2018-01-01$16.84Not available in this settingRVU18AR1
2017-10-01$20.53Not available in this settingRVU17D
2017-07-01$20.53Not available in this settingRVU17C
2017-04-01$20.53Not available in this settingRVU17B
2017-01-01$20.53Not available in this settingRVU17A
2016-10-01$20.05Not available in this settingRVU16D
2016-07-01$20.05Not available in this settingRVU16C
2016-04-01$20.05Not available in this settingRVU16B
2016-01-01$20.05Not available in this settingRVU16A
2015-10-01$20.13Not available in this settingRVU15D
2015-07-01$20.13Not available in this settingRVU15C
2015-04-01$20.03Not available in this settingRVU15B
2015-01-01$20.03Not available in this settingRVU15A
2014-10-01$20.13Not available in this settingRVU14D
2014-07-01$20.13Not available in this settingRVU14C
2014-04-01$20.13Not available in this settingRVU14B
2014-01-01$20.13Not available in this settingRVU14A
2013-10-01Rate data unavailableNot available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 97016 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

97016 billing questions

How many units can be billed for vasopneumatic treatment?

Report one unit per date of service. A longer application or treatment of multiple areas does not increase the unit count.

Can cold packs be billed separately when the vasopneumatic device also delivers cold?

Do not separately report a cold pack for cold delivered as part of the vasopneumatic device treatment.

Does the therapist need to stay with the patient the entire time?

No. Vasopneumatic therapy is a supervised modality; it does not require the constant one-on-one attendance required for timed modalities such as ultrasound.

Which therapy modifier goes on this code?

Use GP for treatment under a physical therapy plan of care or GO under an occupational therapy plan of care. Do not use a professional component modifier.

Can a home pneumatic compression pump be billed with this code?

No. This code reports supervised outpatient treatment, not a pump or sleeve supplied for home use as durable medical equipment.

What documentation supports medical necessity?

Document the cause and extent of swelling, its effect on function, the area treated, treatment duration, and the patient's response. Girth or volume measurements can help show progress over the course of care.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 97016PPRRVU2026_Oct_nonQPP.csv, line 12,846 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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