CPT code 97018: Paraffin therapy, superficial heat modality2026 Medicare rate & RVUs in Virginia
Paraffin bath therapy applies therapeutic heat, commonly to a hand or wrist, as a physical or occupational therapy modality.
In Virginia, Medicare pays $5.85 for 97018 in the office.
Check a contract rate as a % of Medicare · 97018 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 97018 covers
Paraffin bath therapy uses warmed paraffin wax to deliver superficial heat to a body area. Physical and occupational therapists commonly use it for a hand or wrist affected by stiffness or pain, often before therapeutic movement or hand-function activities. The patient immerses the area in the wax or has wax applied, and the therapist manages the treatment and monitors the area.
Report 97018 for the paraffin modality itself, not for exercise or other skilled treatment performed during the visit. Documentation should identify the treated area, the clinical reason for heat, and the treatment provided. This is a therapy service, so a professional-component modifier does not apply. When multiple therapy units are reported for the same patient on the same day, CMS reduces practice expense 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 Virginia compares for 97018
Across 109 of 109 payment localities, the office rate for 97018 runs from $5.33 in Arkansas to $7.70 in San Benito County, CA. Virginia pays $5.85. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$5.85
- Los Angeles, CA · California$6.65+$0.80
- Washington, DC area · District of Columbia$6.81+$0.96
- Miami, FL · Florida$6.67+$0.82
- Chicago, IL · Illinois$6.48+$0.63
- Manhattan, NY · New York$6.93+$1.08
- Alaska · Alaska$7.10+$1.25
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $5.41 | — |
| ArkansasArkansas | $5.33 | — |
| ArizonaArizona | $5.85 | — |
| Bakersfield, CACalifornia | $6.27 | — |
| Chico, CACalifornia | $6.24 | — |
| El Centro, CACalifornia | $6.25 | — |
| Fresno, CACalifornia | $6.24 | — |
| Hanford, CACalifornia | $6.24 | — |
| Madera, CACalifornia | $6.24 | — |
| Merced, CACalifornia | $6.24 | — |
| Modesto, CACalifornia | $6.24 | — |
| Napa, CACalifornia | $7.14 | — |
| Oxnard, CACalifornia | $6.61 | — |
| Redding, CACalifornia | $6.24 | — |
| Rest of CaliforniaCalifornia | $6.24 | — |
| Riverside, CACalifornia | $6.35 | — |
| Sacramento, CACalifornia | $6.53 | — |
| Salinas, CACalifornia | $6.50 | — |
| San Diego, CACalifornia | $6.64 | — |
| Marin County, CACalifornia | $7.53 | — |
| San Francisco, CACalifornia | $7.52 | — |
| San Benito County, CACalifornia | $7.70 | — |
| Santa Clara County, CACalifornia | $7.66 | — |
| San Luis Obispo, CACalifornia | $6.40 | — |
| Santa Cruz, CACalifornia | $6.69 | — |
| Santa Maria, CACalifornia | $6.52 | — |
| Santa Rosa, CACalifornia | $6.75 | — |
| Stockton, CACalifornia | $6.24 | — |
| Vallejo, CACalifornia | $7.13 | — |
| Visalia, CACalifornia | $6.24 | — |
| Yuba City, CACalifornia | $6.24 | — |
| ColoradoColorado | $6.20 | — |
| ConnecticutConnecticut | $6.41 | — |
| DelawareDelaware | $5.94 | — |
| Fort Lauderdale, FLFlorida | $6.33 | — |
| Rest of FloridaFlorida | $6.02 | — |
| Atlanta, GAGeorgia | $6.14 | — |
| Rest of GeorgiaGeorgia | $5.68 | — |
| Hawaii, Guam, HIHawaii | $6.37 | — |
| IowaIowa | $5.50 | — |
| IdahoIdaho | $5.54 | — |
| East St. Louis, ILIllinois | $6.06 | — |
| Rest of IllinoisIllinois | $5.88 | — |
| Suburban Chicago, ILIllinois | $6.38 | — |
| IndianaIndiana | $5.57 | — |
| KansasKansas | $5.49 | — |
| KentuckyKentucky | $5.58 | — |
| New Orleans, LALouisiana | $5.84 | — |
| Rest of LouisianaLouisiana | $5.58 | — |
| Metropolitan Boston, MAMassachusetts | $6.77 | — |
| Rest of MassachusettsMassachusetts | $6.17 | — |
| Baltimore area, MDMaryland | $6.39 | — |
| Rest of MarylandMaryland | $6.05 | — |
| Rest of MaineMaine | $5.59 | — |
| Southern Maine, MEMaine | $5.86 | — |
| Detroit, MIMichigan | $6.11 | — |
| Rest of MichiganMichigan | $5.74 | — |
| MinnesotaMinnesota | $5.88 | — |
| Metropolitan Kansas City, MOMissouri | $5.78 | — |
| Metropolitan St. Louis, MOMissouri | $5.84 | — |
| Rest of MissouriMissouri | $5.50 | — |
| MississippiMississippi | $5.41 | — |
| MontanaMontana | $6.01 | — |
| North CarolinaNorth Carolina | $5.65 | — |
| North DakotaNorth Dakota | $5.81 | — |
| NebraskaNebraska | $5.52 | — |
| New HampshireNew Hampshire | $6.12 | — |
| Northern New JerseyNew Jersey | $6.75 | — |
| Rest of New JerseyNew Jersey | $6.46 | — |
| New MexicoNew Mexico | $5.77 | — |
| NevadaNevada | $5.96 | — |
| NYC suburbs and Long Island, NYNew York | $7.12 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $6.52 | — |
| Queens, NYNew York | $6.96 | — |
| Rest of New YorkNew York | $5.73 | — |
| OhioOhio | $5.70 | — |
| OklahomaOklahoma | $5.54 | — |
| Portland, OROregon | $6.37 | — |
| Rest of OregonOregon | $5.90 | — |
| Metropolitan Philadelphia, PAPennsylvania | $6.26 | — |
| Rest of PennsylvaniaPennsylvania | $5.69 | — |
| Puerto RicoPuerto Rico | $6.05 | — |
| Rhode IslandRhode Island | $6.14 | — |
| South CarolinaSouth Carolina | $5.68 | — |
| South DakotaSouth Dakota | $5.79 | — |
| TennesseeTennessee | $5.52 | — |
| Austin, TXTexas | $6.19 | — |
| Beaumont, TXTexas | $5.66 | — |
| Brazoria, TXTexas | $5.92 | — |
| Dallas, TXTexas | $5.97 | — |
| Fort Worth, TXTexas | $5.94 | — |
| Galveston, TXTexas | $5.95 | — |
| Houston, TXTexas | $6.13 | — |
| Rest of TexasTexas | $5.79 | — |
| UtahUtah | $5.76 | — |
| Virgin Islands, VIUnited States Virgin Islands | $6.05 | — |
| VermontVermont | $5.81 | — |
| Rest of WashingtonWashington | $6.15 | — |
| King County, WAWashington | $6.89 | — |
| WisconsinWisconsin | $5.63 | — |
| West VirginiaWest Virginia | $5.67 | — |
| WyomingWyoming | $5.93 | — |
97018 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.
$5.33
$7.10
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 | $7.10 | 1 |
| AL | $5.41 | 1 |
| AR | $5.33 | 1 |
| AZ | $5.85 | 1 |
| CA | $6.24–$7.70 | 29 |
| CO | $6.20 | 1 |
| CT | $6.41 | 1 |
| DC | $6.81 | 1 |
| DE | $5.94 | 1 |
| FL | $6.02–$6.67 | 3 |
| GA | $5.68–$6.14 | 2 |
| GU | $6.37 | 1 |
| HI | $6.37 | 1 |
| IA | $5.50 | 1 |
| ID | $5.54 | 1 |
| IL | $5.88–$6.48 | 4 |
| IN | $5.57 | 1 |
| KS | $5.49 | 1 |
| KY | $5.58 | 1 |
| LA | $5.58–$5.84 | 2 |
| MA | $6.17–$6.77 | 2 |
| MD | $6.05–$6.81 | 3 |
| ME | $5.59–$5.86 | 2 |
| MI | $5.74–$6.11 | 2 |
| MN | $5.88 | 1 |
| MO | $5.50–$5.84 | 3 |
| MS | $5.41 | 1 |
| MT | $6.01 | 1 |
| NC | $5.65 | 1 |
| ND | $5.81 | 1 |
| NE | $5.52 | 1 |
| NH | $6.12 | 1 |
| NJ | $6.46–$6.75 | 2 |
| NM | $5.77 | 1 |
| NV | $5.96 | 1 |
| NY | $5.73–$7.12 | 5 |
| OH | $5.70 | 1 |
| OK | $5.54 | 1 |
| OR | $5.90–$6.37 | 2 |
| PA | $5.69–$6.26 | 2 |
| PR | $6.05 | 1 |
| RI | $6.14 | 1 |
| SC | $5.68 | 1 |
| SD | $5.79 | 1 |
| TN | $5.52 | 1 |
| TX | $5.66–$6.19 | 8 |
| UT | $5.76 | 1 |
| VA | $5.85–$6.81 | 2 |
| VI | $6.05 | 1 |
| VT | $5.81 | 1 |
| WA | $6.15–$6.89 | 2 |
| WI | $5.63 | 1 |
| WV | $5.67 | 1 |
| WY | $5.93 | 1 |
How the 97018 rate is calculated
Each of 97018’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 · 97018
RVUs × geographic indexes × conversion factor
Work0.06
0.06 RVUs× 1.000 GPCI
Practice expense0.11
0.11 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.1800
Conversion factor
$33.4009
Medicare rate
$6.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,847
- Code
- 97018
- Physician work
- 0.06
- Practice expense
- 0.11
- Malpractice
- 0.01
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.06 | × 1.000 | 0.0600 |
| Practice expense | 0.11 | × 0.983 | 0.1081 |
| Malpractice | 0.01 | × 0.706 | 0.0071 |
| Total RVUs | 0.1752 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virginia$5.85
Office: (0.06 × 1 + 0.11 × 0.983 + 0.01 × 0.706) × $33.4009 = $5.85
Payment rules and modifiers for 97018
The CMS indicators that decide how 97018 is paid alongside other services.
CMS payment indicators · 97018
Paraffin therapy, superficial heat 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
97018 without CQ · national office
$6.01
Paraffin therapy, superficial heat modality
97018-CQ · Allowed amount unchanged
$6.01
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 97018 has changed in Virginia
97018 · Office / nonfacility
$5.85
Effective 2026-10-01
The base rate is $0.16 lower than on 2025-10-01, moving from $6.01 to $5.85 (2.7%).
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
$6.01changed to$5.85
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.12 changed to 0.11
- Work GPCI 1.002 changed to 1.000
- Practice expense GPCI 0.984 changed to 0.983
- Malpractice GPCI 0.755 changed to 0.706
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$5.53changed to$6.01
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.10 changed to 0.12
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$5.44changed to$5.53
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$5.67changed to$5.44
- Conversion factor 33.8872 changed to 32.7442
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 0.990 changed to 0.984
- Malpractice GPCI 0.826 changed to 0.755
January 1, 2023
RVU23A
$5.83changed to$5.67
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.995 changed to 0.990
- Malpractice GPCI 0.897 changed to 0.826
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$5.88changed to$5.83
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$6.07changed to$5.88
- Conversion factor 36.0896 changed to 34.8931
- Practice expense GPCI 0.991 changed to 0.995
- Malpractice GPCI 0.903 changed to 0.897
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$7.11changed to$6.07
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.13 changed to 0.10
- Practice expense GPCI 0.986 changed to 0.991
- Malpractice GPCI 0.908 changed to 0.903
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$8.88changed to$7.11
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.18 changed to 0.13
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$10.95changed to$8.88
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.24 changed to 0.18
- Practice expense GPCI 0.985 changed to 0.986
- Malpractice GPCI 0.866 changed to 0.908
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$10.89changed to$10.95
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.983 changed to 0.985
- Malpractice GPCI 0.824 changed to 0.866
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$10.93changed to$10.89
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$10.88changed to$10.93
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$10.85changed to$10.88
- Conversion factor 35.8228 changed to 35.7547
- Practice expense GPCI 0.980 changed to 0.983
- Malpractice GPCI 0.778 changed to 0.824
Held through RVU15B.
January 1, 2014
RVU14A
$10.93changed to$10.85
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.26 changed to 0.24
- Practice expense GPCI 0.977 changed to 0.980
- Malpractice GPCI 0.731 changed to 0.778
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $10.93
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $5.85 | Not available in this setting | RVU26D |
| 2026-07-01 | $5.85 | Not available in this setting | RVU26C |
| 2026-04-01 | $5.85 | Not available in this setting | RVU26B |
| 2026-01-01 | $5.85 | Not available in this setting | RVU26A |
| 2025-10-01 | $6.01 | Not available in this setting | RVU25D |
| 2025-07-01 | $6.01 | Not available in this setting | RVU25C |
| 2025-04-01 | $6.01 | Not available in this setting | RVU25B |
| 2025-01-01 | $6.01 | Not available in this setting | RVU25A |
| 2024-10-01 | $5.53 | Not available in this setting | RVU24D |
| 2024-07-01 | $5.53 | Not available in this setting | RVU24C |
| 2024-04-01 | $5.53 | Not available in this setting | RVU24B |
| 2024-03-09 | $5.53 | Not available in this setting | RVU24AR |
| 2024-01-01 | $5.44 | Not available in this setting | RVU24A |
| 2023-10-01 | $5.67 | Not available in this setting | RVU23D |
| 2023-07-01 | $5.67 | Not available in this setting | RVU23C |
| 2023-04-01 | $5.67 | Not available in this setting | RVU23B |
| 2023-01-01 | $5.67 | Not available in this setting | RVU23A |
| 2022-10-01 | $5.83 | Not available in this setting | RVU22D |
| 2022-07-01 | $5.83 | Not available in this setting | RVU22C |
| 2022-04-01 | $5.83 | Not available in this setting | RVU22B |
| 2022-01-01 | $5.83 | Not available in this setting | RVU22A |
| 2021-10-01 | $5.88 | Not available in this setting | RVU21D |
| 2021-07-01 | $5.88 | Not available in this setting | RVU21C |
| 2021-04-01 | $5.88 | Not available in this setting | RVU21B |
| 2021-01-01 | $5.88 | Not available in this setting | RVU21A |
| 2020-10-01 | $6.07 | Not available in this setting | RVU20D |
| 2020-07-01 | $6.07 | Not available in this setting | RVU20C |
| 2020-04-01 | $6.07 | Not available in this setting | RVU20B |
| 2020-01-01 | $6.07 | Not available in this setting | RVU20A |
| 2019-10-01 | $7.11 | Not available in this setting | RVU19D |
| 2019-07-01 | $7.11 | Not available in this setting | RVU19C |
| 2019-04-01 | $7.11 | Not available in this setting | RVU19B |
| 2019-01-01 | $7.11 | Not available in this setting | RVU19A |
| 2018-10-01 | $8.88 | Not available in this setting | RVU18D |
| 2018-07-01 | $8.88 | Not available in this setting | RVU18C |
| 2018-04-01 | $8.88 | Not available in this setting | RVU18B |
| 2018-01-01 | $8.88 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $10.95 | Not available in this setting | RVU17D |
| 2017-07-01 | $10.95 | Not available in this setting | RVU17C |
| 2017-04-01 | $10.95 | Not available in this setting | RVU17B |
| 2017-01-01 | $10.95 | Not available in this setting | RVU17A |
| 2016-10-01 | $10.89 | Not available in this setting | RVU16D |
| 2016-07-01 | $10.89 | Not available in this setting | RVU16C |
| 2016-04-01 | $10.89 | Not available in this setting | RVU16B |
| 2016-01-01 | $10.89 | Not available in this setting | RVU16A |
| 2015-10-01 | $10.93 | Not available in this setting | RVU15D |
| 2015-07-01 | $10.93 | Not available in this setting | RVU15C |
| 2015-04-01 | $10.88 | Not available in this setting | RVU15B |
| 2015-01-01 | $10.88 | Not available in this setting | RVU15A |
| 2014-10-01 | $10.85 | Not available in this setting | RVU14D |
| 2014-07-01 | $10.85 | Not available in this setting | RVU14C |
| 2014-04-01 | $10.85 | Not available in this setting | RVU14B |
| 2014-01-01 | $10.85 | Not available in this setting | RVU14A |
| 2013-10-01 | $10.93 | Not available in this setting | RVU13D |
| 2013-07-01 | $10.93 | Not available in this setting | RVU13C |
| 2013-04-01 | $10.93 | Not available in this setting | RVU13B |
| 2013-01-01 | $10.93 | Not available in this setting | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
97018 billing questions
When should 97018 be chosen over hot or cold packs?
Use 97018 when paraffin wax is the heat-delivery method. Hot or cold packs are reported with 97010 when packs, rather than a paraffin bath, provide the modality.
Is 97018 reported per 15 minutes?
The code represents paraffin bath therapy and is not a 15-minute timed modality code. Do not calculate units from the timed structure used by codes such as 97034.
Can therapeutic exercise be reported in the same visit?
Yes, when the therapist separately provides and documents skilled therapeutic exercise. The paraffin modality alone does not describe that exercise.
Should modifier 26 be appended?
No. CMS identifies 97018 as a therapy service for which the professional-component modifier does not apply.
What documentation supports reporting 97018?
Record the treated body area, the condition or functional problem prompting heat, and that paraffin therapy was administered. Document separately any distinct skilled treatment performed during the encounter.
How does the therapy multiple procedure reduction affect 97018?
When multiple therapy units are reported on the same day, CMS reduces practice expense for the second and later units. The reduction concerns practice expense, not a change in the service documented.
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
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