CPT code 97016: Vasopneumatic therapy, supervised, untimed compression modality2026 Medicare rate & RVUs in Utah
Report supervised vasopneumatic compression therapy for swelling after injury or surgery, or for lymphedema, when a device applies cyclic pressure.
In Utah, Medicare pays $11.65 for 97016 in the office.
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.
On this page 11 sections
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 Utah 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. Utah pays $11.65. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Utah · this page$11.65
- Los Angeles, CA · California$13.20+$1.55
- Washington, DC area · District of Columbia$13.40+$1.75
- Miami, FL · Florida$12.77+$1.12
- Chicago, IL · Illinois$12.53+$0.88
- Manhattan, NY · New York$13.52+$1.87
- Alaska · Alaska$15.25+$3.60
Other areas in Utah first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $12.52 | — |
| Merced, CACalifornia | $12.52 | — |
| Modesto, CACalifornia | $12.52 | — |
| Napa, CACalifornia | $14.04 | — |
| Oxnard, CACalifornia | $13.10 | — |
| Redding, CACalifornia | $12.52 | — |
| Rest of CaliforniaCalifornia | $12.52 | — |
| Riverside, CACalifornia | $12.63 | — |
| Sacramento, CACalifornia | $13.01 | — |
| Salinas, CACalifornia | $12.96 | — |
| San Diego, CACalifornia | $13.16 | — |
| Marin County, CACalifornia | $14.74 | — |
| San Francisco, CACalifornia | $14.73 | — |
| San Benito County, CACalifornia | $15.04 | — |
| Santa Clara County, CACalifornia | $14.99 | — |
| San Luis Obispo, CACalifornia | $12.76 | — |
| Santa Cruz, CACalifornia | $13.22 | — |
| Santa Maria, CACalifornia | $12.98 | — |
| Santa Rosa, CACalifornia | $13.34 | — |
| Stockton, CACalifornia | $12.52 | — |
| Vallejo, CACalifornia | $14.03 | — |
| Visalia, CACalifornia | $12.52 | — |
| Yuba City, CACalifornia | $12.52 | — |
| ColoradoColorado | $12.39 | — |
| ConnecticutConnecticut | $12.65 | — |
| DelawareDelaware | $11.95 | — |
| Fort Lauderdale, FLFlorida | $12.37 | — |
| Rest of FloridaFlorida | $11.94 | — |
| Atlanta, GAGeorgia | $12.20 | — |
| Rest of GeorgiaGeorgia | $11.48 | — |
| Hawaii, Guam, HIHawaii | $12.66 | — |
| IowaIowa | $11.34 | — |
| IdahoIdaho | $11.39 | — |
| East St. Louis, ILIllinois | $11.91 | — |
| Rest of IllinoisIllinois | $11.72 | — |
| Suburban Chicago, ILIllinois | $12.48 | — |
| IndianaIndiana | $11.44 | — |
| KansasKansas | $11.31 | — |
| KentuckyKentucky | $11.37 | — |
| New Orleans, LALouisiana | $11.73 | — |
| Rest of LouisianaLouisiana | $11.36 | — |
| Metropolitan Boston, MAMassachusetts | $13.34 | — |
| Rest of MassachusettsMassachusetts | $12.35 | — |
| Baltimore area, MDMaryland | $12.61 | — |
| Rest of MarylandMaryland | $12.13 | — |
| Rest of MaineMaine | $11.44 | — |
| Southern Maine, MEMaine | $11.85 | — |
| Detroit, MIMichigan | $12.05 | — |
| Rest of MichiganMichigan | $11.57 | — |
| MinnesotaMinnesota | $11.95 | — |
| Metropolitan Kansas City, MOMissouri | $11.67 | — |
| Metropolitan St. Louis, MOMissouri | $11.75 | — |
| Rest of MissouriMissouri | $11.23 | — |
| MississippiMississippi | $11.15 | — |
| MontanaMontana | $12.02 | — |
| North CarolinaNorth Carolina | $11.52 | — |
| North DakotaNorth Dakota | $11.83 | — |
| NebraskaNebraska | $11.38 | — |
| New HampshireNew Hampshire | $12.22 | — |
| Northern New JerseyNew Jersey | $13.33 | — |
| Rest of New JerseyNew Jersey | $12.82 | — |
| New MexicoNew Mexico | $11.62 | — |
| NevadaNevada | $11.97 | — |
| NYC suburbs and Long Island, NYNew York | $13.77 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $12.90 | — |
| Queens, NYNew York | $13.59 | — |
| Rest of New YorkNew York | $11.64 | — |
| OhioOhio | $11.53 | — |
| OklahomaOklahoma | $11.34 | — |
| Portland, OROregon | $12.67 | — |
| Rest of OregonOregon | $11.90 | — |
| Metropolitan Philadelphia, PAPennsylvania | $12.43 | — |
| Rest of PennsylvaniaPennsylvania | $11.54 | — |
| Puerto RicoPuerto Rico | $12.08 | — |
| Rhode IslandRhode Island | $12.29 | — |
| South CarolinaSouth Carolina | $11.54 | — |
| South DakotaSouth Dakota | $11.80 | — |
| TennesseeTennessee | $11.35 | — |
| Austin, TXTexas | $12.33 | — |
| Beaumont, TXTexas | $11.49 | — |
| Brazoria, TXTexas | $11.95 | — |
| Dallas, TXTexas | $12.01 | — |
| Fort Worth, TXTexas | $11.96 | — |
| Galveston, TXTexas | $11.98 | — |
| Houston, TXTexas | $12.16 | — |
| Rest of TexasTexas | $11.70 | — |
| VirginiaVirginia | $11.83 | — |
| Virgin Islands, VIUnited States Virgin Islands | $12.08 | — |
| VermontVermont | $11.80 | — |
| Rest of WashingtonWashington | $12.32 | — |
| King County, WAWashington | $13.55 | — |
| WisconsinWisconsin | $11.55 | — |
| West VirginiaWest Virginia | $11.42 | — |
| WyomingWyoming | $11.94 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $15.25 | 1 |
| AL | $11.17 | 1 |
| AR | $11.06 | 1 |
| AZ | $11.80 | 1 |
| CA | $12.52–$15.04 | 29 |
| CO | $12.39 | 1 |
| CT | $12.65 | 1 |
| DC | $13.40 | 1 |
| DE | $11.95 | 1 |
| FL | $11.94–$12.77 | 3 |
| GA | $11.48–$12.20 | 2 |
| GU | $12.66 | 1 |
| HI | $12.66 | 1 |
| IA | $11.34 | 1 |
| ID | $11.39 | 1 |
| IL | $11.72–$12.53 | 4 |
| IN | $11.44 | 1 |
| KS | $11.31 | 1 |
| KY | $11.37 | 1 |
| LA | $11.36–$11.73 | 2 |
| MA | $12.35–$13.34 | 2 |
| MD | $12.13–$13.40 | 3 |
| ME | $11.44–$11.85 | 2 |
| MI | $11.57–$12.05 | 2 |
| MN | $11.95 | 1 |
| MO | $11.23–$11.75 | 3 |
| MS | $11.15 | 1 |
| MT | $12.02 | 1 |
| NC | $11.52 | 1 |
| ND | $11.83 | 1 |
| NE | $11.38 | 1 |
| NH | $12.22 | 1 |
| NJ | $12.82–$13.33 | 2 |
| NM | $11.62 | 1 |
| NV | $11.97 | 1 |
| NY | $11.64–$13.77 | 5 |
| OH | $11.53 | 1 |
| OK | $11.34 | 1 |
| OR | $11.90–$12.67 | 2 |
| PA | $11.54–$12.43 | 2 |
| PR | $12.08 | 1 |
| RI | $12.29 | 1 |
| SC | $11.54 | 1 |
| SD | $11.80 | 1 |
| TN | $11.35 | 1 |
| TX | $11.49–$12.33 | 8 |
| UT | $11.65 | 1 |
| VA | $11.83–$13.40 | 2 |
| VI | $12.08 | 1 |
| VT | $11.80 | 1 |
| WA | $12.32–$13.55 | 2 |
| WI | $11.55 | 1 |
| WV | $11.42 | 1 |
| WY | $11.94 | 1 |
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
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 Utah 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
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.18 | × 1.000 | 0.1800 |
| Practice expense | 0.17 | × 0.940 | 0.1598 |
| Malpractice | 0.01 | × 0.898 | 0.0090 |
| Total RVUs | 0.3488 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Utah$11.65
Office: (0.18 × 1 + 0.17 × 0.94 + 0.01 × 0.898) × $33.4009 = $11.65
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 5 | Therapy reduction: practice expense of the second and later units is reduced. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 7 | Therapy 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 Utah
97016 · Office / nonfacility
$11.65
Effective 2026-10-01
The base rate is $0.40 higher than on 2025-10-01, moving from $11.25 to $11.65 (3.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$11.25changed to$11.65
- Conversion factor 32.3465 changed to 33.4009
- Practice expense GPCI 0.933 changed to 0.940
- Malpractice GPCI 0.930 changed to 0.898
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$11.27changed to$11.25
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.16 changed to 0.17
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$11.09changed to$11.27
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$11.41changed to$11.09
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.865 changed to 0.930
January 1, 2023
RVU23A
$11.59changed to$11.41
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.919 changed to 0.926
- Malpractice GPCI 0.799 changed to 0.865
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$11.69changed to$11.59
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$12.18changed to$11.69
- Conversion factor 36.0896 changed to 34.8931
- Practice expense GPCI 0.923 changed to 0.919
- Malpractice GPCI 0.982 changed to 0.799
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$12.59changed to$12.18
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.17 changed to 0.16
- Practice expense GPCI 0.927 changed to 0.923
- Malpractice GPCI 1.165 changed to 0.982
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$15.58changed to$12.59
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.26 changed to 0.17
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$18.83changed to$15.58
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.36 changed to 0.26
- Practice expense GPCI 0.925 changed to 0.927
- Malpractice GPCI 1.167 changed to 1.165
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$18.42changed to$18.83
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.35 changed to 0.36
- Practice expense GPCI 0.922 changed to 0.925
- Malpractice GPCI 1.169 changed to 1.167
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$18.48changed to$18.42
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$18.39changed to$18.48
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$18.38changed to$18.39
- Conversion factor 35.8228 changed to 35.7547
- Practice expense GPCI 0.919 changed to 0.922
- Malpractice GPCI 1.136 changed to 1.169
Held through RVU15B.
January 1, 2014
RVU14A
$18.65changed to$18.38
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.39 changed to 0.35
- Practice expense GPCI 0.916 changed to 0.919
- Malpractice GPCI 1.102 changed to 1.136
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $18.65
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $11.65 | Not available in this setting | RVU26D |
| 2026-07-01 | $11.65 | Not available in this setting | RVU26C |
| 2026-04-01 | $11.65 | Not available in this setting | RVU26B |
| 2026-01-01 | $11.65 | Not available in this setting | RVU26A |
| 2025-10-01 | $11.25 | Not available in this setting | RVU25D |
| 2025-07-01 | $11.25 | Not available in this setting | RVU25C |
| 2025-04-01 | $11.25 | Not available in this setting | RVU25B |
| 2025-01-01 | $11.25 | Not available in this setting | RVU25A |
| 2024-10-01 | $11.27 | Not available in this setting | RVU24D |
| 2024-07-01 | $11.27 | Not available in this setting | RVU24C |
| 2024-04-01 | $11.27 | Not available in this setting | RVU24B |
| 2024-03-09 | $11.27 | Not available in this setting | RVU24AR |
| 2024-01-01 | $11.09 | Not available in this setting | RVU24A |
| 2023-10-01 | $11.41 | Not available in this setting | RVU23D |
| 2023-07-01 | $11.41 | Not available in this setting | RVU23C |
| 2023-04-01 | $11.41 | Not available in this setting | RVU23B |
| 2023-01-01 | $11.41 | Not available in this setting | RVU23A |
| 2022-10-01 | $11.59 | Not available in this setting | RVU22D |
| 2022-07-01 | $11.59 | Not available in this setting | RVU22C |
| 2022-04-01 | $11.59 | Not available in this setting | RVU22B |
| 2022-01-01 | $11.59 | Not available in this setting | RVU22A |
| 2021-10-01 | $11.69 | Not available in this setting | RVU21D |
| 2021-07-01 | $11.69 | Not available in this setting | RVU21C |
| 2021-04-01 | $11.69 | Not available in this setting | RVU21B |
| 2021-01-01 | $11.69 | Not available in this setting | RVU21A |
| 2020-10-01 | $12.18 | Not available in this setting | RVU20D |
| 2020-07-01 | $12.18 | Not available in this setting | RVU20C |
| 2020-04-01 | $12.18 | Not available in this setting | RVU20B |
| 2020-01-01 | $12.18 | Not available in this setting | RVU20A |
| 2019-10-01 | $12.59 | Not available in this setting | RVU19D |
| 2019-07-01 | $12.59 | Not available in this setting | RVU19C |
| 2019-04-01 | $12.59 | Not available in this setting | RVU19B |
| 2019-01-01 | $12.59 | Not available in this setting | RVU19A |
| 2018-10-01 | $15.58 | Not available in this setting | RVU18D |
| 2018-07-01 | $15.58 | Not available in this setting | RVU18C |
| 2018-04-01 | $15.58 | Not available in this setting | RVU18B |
| 2018-01-01 | $15.58 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $18.83 | Not available in this setting | RVU17D |
| 2017-07-01 | $18.83 | Not available in this setting | RVU17C |
| 2017-04-01 | $18.83 | Not available in this setting | RVU17B |
| 2017-01-01 | $18.83 | Not available in this setting | RVU17A |
| 2016-10-01 | $18.42 | Not available in this setting | RVU16D |
| 2016-07-01 | $18.42 | Not available in this setting | RVU16C |
| 2016-04-01 | $18.42 | Not available in this setting | RVU16B |
| 2016-01-01 | $18.42 | Not available in this setting | RVU16A |
| 2015-10-01 | $18.48 | Not available in this setting | RVU15D |
| 2015-07-01 | $18.48 | Not available in this setting | RVU15C |
| 2015-04-01 | $18.39 | Not available in this setting | RVU15B |
| 2015-01-01 | $18.39 | Not available in this setting | RVU15A |
| 2014-10-01 | $18.38 | Not available in this setting | RVU14D |
| 2014-07-01 | $18.38 | Not available in this setting | RVU14C |
| 2014-04-01 | $18.38 | Not available in this setting | RVU14B |
| 2014-01-01 | $18.38 | Not available in this setting | RVU14A |
| 2013-10-01 | $18.65 | Not available in this setting | RVU13D |
| 2013-07-01 | $18.65 | Not available in this setting | RVU13C |
| 2013-04-01 | $18.65 | Not available in this setting | RVU13B |
| 2013-01-01 | $18.65 | Not available in this setting | RVU13AR |
Where the Utah rate applies
Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.
- Alpine
- Alta
- Altamont
- Alton
- Amalga
- American Fork
- Aneth
- Annabella
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
Fee sheets
Put 97016 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet