CPT code 97026: Infrared therapy2026 Medicare rate & RVUs in South Dakota
Reports application of infrared heat to a selected body area when the service is medically necessary and meets Medicare's limited coverage circumstances.
In South Dakota, Medicare pays $6.46 for 97026 in the office.
Check a contract rate as a % of Medicare · 97026 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 97026 covers
Code 97026 represents therapeutic application of infrared heat, typically from an infrared lamp, to one or more body areas. Physical and occupational therapists may use it for localized pain or stiffness, including as a preparatory modality before movement or other skilled treatment. It is an untimed modality used in outpatient rehabilitation and clinician office settings.
Report the service only when infrared treatment is medically necessary and the case falls within Medicare's restricted coverage circumstances; a therapy diagnosis alone does not establish coverage. Document the treated area, clinical rationale, modality provided, and its relationship to the therapy plan. A professional-component modifier does not apply. CMS reduces practice expense for the second and later therapy units furnished on the same day. Because 97026 is untimed, do not count 15-minute increments.
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 South Dakota compares for 97026
Across 109 of 109 payment localities, the office rate for 97026 runs from $5.91 in Arkansas to $8.66 in San Benito County, CA. South Dakota pays $6.46. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$6.46
- Los Angeles, CA · California$7.44+$0.98
- Washington, DC area · District of Columbia$7.60+$1.14
- Miami, FL · Florida$7.37+$0.91
- Chicago, IL · Illinois$7.15+$0.69
- Manhattan, NY · New York$7.71+$1.25
- Alaska · Alaska$7.81+$1.35
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $5.99 | — |
| ArkansasArkansas | $5.91 | — |
| ArizonaArizona | $6.50 | — |
| Bakersfield, CACalifornia | $7.00 | — |
| Chico, CACalifornia | $6.98 | — |
| El Centro, CACalifornia | $6.98 | — |
| Fresno, CACalifornia | $6.98 | — |
| Hanford, CACalifornia | $6.98 | — |
| Madera, CACalifornia | $6.98 | — |
| Merced, CACalifornia | $6.98 | — |
| Modesto, CACalifornia | $6.98 | — |
| Napa, CACalifornia | $8.02 | — |
| Oxnard, CACalifornia | $7.40 | — |
| Redding, CACalifornia | $6.98 | — |
| Rest of CaliforniaCalifornia | $6.98 | — |
| Riverside, CACalifornia | $7.08 | — |
| Sacramento, CACalifornia | $7.31 | — |
| Salinas, CACalifornia | $7.28 | — |
| San Diego, CACalifornia | $7.44 | — |
| Marin County, CACalifornia | $8.47 | — |
| San Francisco, CACalifornia | $8.46 | — |
| San Benito County, CACalifornia | $8.66 | — |
| Santa Clara County, CACalifornia | $8.62 | — |
| San Luis Obispo, CACalifornia | $7.16 | — |
| Santa Cruz, CACalifornia | $7.50 | — |
| Santa Maria, CACalifornia | $7.30 | — |
| Santa Rosa, CACalifornia | $7.58 | — |
| Stockton, CACalifornia | $6.98 | — |
| Vallejo, CACalifornia | $8.01 | — |
| Visalia, CACalifornia | $6.98 | — |
| Yuba City, CACalifornia | $6.98 | — |
| ColoradoColorado | $6.91 | — |
| ConnecticutConnecticut | $7.12 | — |
| DelawareDelaware | $6.60 | — |
| Fort Lauderdale, FLFlorida | $7.01 | — |
| Rest of FloridaFlorida | $6.66 | — |
| Atlanta, GAGeorgia | $6.82 | — |
| Rest of GeorgiaGeorgia | $6.28 | — |
| Hawaii, Guam, HIHawaii | $7.13 | — |
| IowaIowa | $6.11 | — |
| IdahoIdaho | $6.16 | — |
| East St. Louis, ILIllinois | $6.67 | — |
| Rest of IllinoisIllinois | $6.49 | — |
| Suburban Chicago, ILIllinois | $7.07 | — |
| IndianaIndiana | $6.19 | — |
| KansasKansas | $6.10 | — |
| KentuckyKentucky | $6.17 | — |
| New Orleans, LALouisiana | $6.47 | — |
| Rest of LouisianaLouisiana | $6.17 | — |
| Metropolitan Boston, MAMassachusetts | $7.57 | — |
| Rest of MassachusettsMassachusetts | $6.87 | — |
| Baltimore area, MDMaryland | $7.11 | — |
| Rest of MarylandMaryland | $6.72 | — |
| Rest of MaineMaine | $6.21 | — |
| Southern Maine, MEMaine | $6.52 | — |
| Detroit, MIMichigan | $6.76 | — |
| Rest of MichiganMichigan | $6.35 | — |
| MinnesotaMinnesota | $6.57 | — |
| Metropolitan Kansas City, MOMissouri | $6.41 | — |
| Metropolitan St. Louis, MOMissouri | $6.47 | — |
| Rest of MissouriMissouri | $6.07 | — |
| MississippiMississippi | $5.99 | — |
| MontanaMontana | $6.68 | — |
| North CarolinaNorth Carolina | $6.27 | — |
| North DakotaNorth Dakota | $6.48 | — |
| NebraskaNebraska | $6.14 | — |
| New HampshireNew Hampshire | $6.82 | — |
| Northern New JerseyNew Jersey | $7.52 | — |
| Rest of New JerseyNew Jersey | $7.19 | — |
| New MexicoNew Mexico | $6.39 | — |
| NevadaNevada | $6.63 | — |
| NYC suburbs and Long Island, NYNew York | $7.92 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $7.25 | — |
| Queens, NYNew York | $7.75 | — |
| Rest of New YorkNew York | $6.36 | — |
| OhioOhio | $6.31 | — |
| OklahomaOklahoma | $6.14 | — |
| Portland, OROregon | $7.11 | — |
| Rest of OregonOregon | $6.56 | — |
| Metropolitan Philadelphia, PAPennsylvania | $6.96 | — |
| Rest of PennsylvaniaPennsylvania | $6.31 | — |
| Puerto RicoPuerto Rico | $6.72 | — |
| Rhode IslandRhode Island | $6.83 | — |
| South CarolinaSouth Carolina | $6.30 | — |
| TennesseeTennessee | $6.13 | — |
| Austin, TXTexas | $6.90 | — |
| Beaumont, TXTexas | $6.27 | — |
| Brazoria, TXTexas | $6.58 | — |
| Dallas, TXTexas | $6.63 | — |
| Fort Worth, TXTexas | $6.59 | — |
| Galveston, TXTexas | $6.61 | — |
| Houston, TXTexas | $6.79 | — |
| Rest of TexasTexas | $6.43 | — |
| UtahUtah | $6.39 | — |
| VirginiaVirginia | $6.51 | — |
| Virgin Islands, VIUnited States Virgin Islands | $6.72 | — |
| VermontVermont | $6.47 | — |
| Rest of WashingtonWashington | $6.86 | — |
| King County, WAWashington | $7.70 | — |
| WisconsinWisconsin | $6.27 | — |
| West VirginiaWest Virginia | $6.26 | — |
| WyomingWyoming | $6.59 | — |
97026 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.
$5.91
$7.82
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 | $7.81 | 1 |
| AL | $5.99 | 1 |
| AR | $5.91 | 1 |
| AZ | $6.50 | 1 |
| CA | $6.98–$8.66 | 29 |
| CO | $6.91 | 1 |
| CT | $7.12 | 1 |
| DC | $7.60 | 1 |
| DE | $6.60 | 1 |
| FL | $6.66–$7.37 | 3 |
| GA | $6.28–$6.82 | 2 |
| GU | $7.13 | 1 |
| HI | $7.13 | 1 |
| IA | $6.11 | 1 |
| ID | $6.16 | 1 |
| IL | $6.49–$7.15 | 4 |
| IN | $6.19 | 1 |
| KS | $6.10 | 1 |
| KY | $6.17 | 1 |
| LA | $6.17–$6.47 | 2 |
| MA | $6.87–$7.57 | 2 |
| MD | $6.72–$7.60 | 3 |
| ME | $6.21–$6.52 | 2 |
| MI | $6.35–$6.76 | 2 |
| MN | $6.57 | 1 |
| MO | $6.07–$6.47 | 3 |
| MS | $5.99 | 1 |
| MT | $6.68 | 1 |
| NC | $6.27 | 1 |
| ND | $6.48 | 1 |
| NE | $6.14 | 1 |
| NH | $6.82 | 1 |
| NJ | $7.19–$7.52 | 2 |
| NM | $6.39 | 1 |
| NV | $6.63 | 1 |
| NY | $6.36–$7.92 | 5 |
| OH | $6.31 | 1 |
| OK | $6.14 | 1 |
| OR | $6.56–$7.11 | 2 |
| PA | $6.31–$6.96 | 2 |
| PR | $6.72 | 1 |
| RI | $6.83 | 1 |
| SC | $6.30 | 1 |
| SD | $6.46 | 1 |
| TN | $6.13 | 1 |
| TX | $6.27–$6.90 | 8 |
| UT | $6.39 | 1 |
| VA | $6.51–$7.60 | 2 |
| VI | $6.72 | 1 |
| VT | $6.47 | 1 |
| WA | $6.86–$7.70 | 2 |
| WI | $6.27 | 1 |
| WV | $6.26 | 1 |
| WY | $6.59 | 1 |
How the 97026 rate is calculated
Each of 97026’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 · 97026
RVUs × geographic indexes × conversion factor
Work0.06
0.06 RVUs× 1.000 GPCI
Practice expense0.13
0.13 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.2000
Conversion factor
$33.4009
Medicare rate
$6.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,850
- Code
- 97026
- Physician work
- 0.06
- Practice expense
- 0.13
- Malpractice
- 0.01
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.06 | × 1.000 | 0.0600 |
| Practice expense | 0.13 | × 1.000 | 0.1300 |
| Malpractice | 0.01 | × 0.336 | 0.0034 |
| Total RVUs | 0.1934 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$6.46
Office: (0.06 × 1 + 0.13 × 1 + 0.01 × 0.336) × $33.4009 = $6.46
Payment rules and modifiers for 97026
The CMS indicators that decide how 97026 is paid alongside other services.
CMS payment indicators · 97026
Infrared therapy
| 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
97026 without CQ · national office
$6.68
Infrared therapy
97026-CQ · Allowed amount unchanged
$6.68
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 97026 has changed in South Dakota
97026 · Office / nonfacility
$6.46
Effective 2026-10-01
The base rate is $0.13 lower than on 2025-10-01, moving from $6.59 to $6.46 (2.0%).
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
$6.59changed to$6.46
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.14 changed to 0.13
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$6.45changed to$6.59
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.13 changed to 0.14
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$6.35changed to$6.45
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$6.56changed to$6.35
- Conversion factor 33.8872 changed to 32.7442
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$6.35changed to$6.56
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.12 changed to 0.13
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$6.40changed to$6.35
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$6.27changed to$6.40
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.11 changed to 0.12
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$6.27changed to$6.27
- Conversion factor 36.0391 changed to 36.0896
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$6.26changed to$6.27
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$5.88changed to$6.26
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.10 changed to 0.11
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$5.87changed to$5.88
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$5.89changed to$5.87
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$5.86changed to$5.89
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$5.88changed to$5.86
- Conversion factor 35.8228 changed to 35.7547
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$5.93changed to$5.88
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.11 changed to 0.10
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $5.93
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $6.46 | Not available in this setting | RVU26D |
| 2026-07-01 | $6.46 | Not available in this setting | RVU26C |
| 2026-04-01 | $6.46 | Not available in this setting | RVU26B |
| 2026-01-01 | $6.46 | Not available in this setting | RVU26A |
| 2025-10-01 | $6.59 | Not available in this setting | RVU25D |
| 2025-07-01 | $6.59 | Not available in this setting | RVU25C |
| 2025-04-01 | $6.59 | Not available in this setting | RVU25B |
| 2025-01-01 | $6.59 | Not available in this setting | RVU25A |
| 2024-10-01 | $6.45 | Not available in this setting | RVU24D |
| 2024-07-01 | $6.45 | Not available in this setting | RVU24C |
| 2024-04-01 | $6.45 | Not available in this setting | RVU24B |
| 2024-03-09 | $6.45 | Not available in this setting | RVU24AR |
| 2024-01-01 | $6.35 | Not available in this setting | RVU24A |
| 2023-10-01 | $6.56 | Not available in this setting | RVU23D |
| 2023-07-01 | $6.56 | Not available in this setting | RVU23C |
| 2023-04-01 | $6.56 | Not available in this setting | RVU23B |
| 2023-01-01 | $6.56 | Not available in this setting | RVU23A |
| 2022-10-01 | $6.35 | Not available in this setting | RVU22D |
| 2022-07-01 | $6.35 | Not available in this setting | RVU22C |
| 2022-04-01 | $6.35 | Not available in this setting | RVU22B |
| 2022-01-01 | $6.35 | Not available in this setting | RVU22A |
| 2021-10-01 | $6.40 | Not available in this setting | RVU21D |
| 2021-07-01 | $6.40 | Not available in this setting | RVU21C |
| 2021-04-01 | $6.40 | Not available in this setting | RVU21B |
| 2021-01-01 | $6.40 | Not available in this setting | RVU21A |
| 2020-10-01 | $6.27 | Not available in this setting | RVU20D |
| 2020-07-01 | $6.27 | Not available in this setting | RVU20C |
| 2020-04-01 | $6.27 | Not available in this setting | RVU20B |
| 2020-01-01 | $6.27 | Not available in this setting | RVU20A |
| 2019-10-01 | $6.27 | Not available in this setting | RVU19D |
| 2019-07-01 | $6.27 | Not available in this setting | RVU19C |
| 2019-04-01 | $6.27 | Not available in this setting | RVU19B |
| 2019-01-01 | $6.27 | Not available in this setting | RVU19A |
| 2018-10-01 | $6.26 | Not available in this setting | RVU18D |
| 2018-07-01 | $6.26 | Not available in this setting | RVU18C |
| 2018-04-01 | $6.26 | Not available in this setting | RVU18B |
| 2018-01-01 | $6.26 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $5.88 | Not available in this setting | RVU17D |
| 2017-07-01 | $5.88 | Not available in this setting | RVU17C |
| 2017-04-01 | $5.88 | Not available in this setting | RVU17B |
| 2017-01-01 | $5.88 | Not available in this setting | RVU17A |
| 2016-10-01 | $5.87 | Not available in this setting | RVU16D |
| 2016-07-01 | $5.87 | Not available in this setting | RVU16C |
| 2016-04-01 | $5.87 | Not available in this setting | RVU16B |
| 2016-01-01 | $5.87 | Not available in this setting | RVU16A |
| 2015-10-01 | $5.89 | Not available in this setting | RVU15D |
| 2015-07-01 | $5.89 | Not available in this setting | RVU15C |
| 2015-04-01 | $5.86 | Not available in this setting | RVU15B |
| 2015-01-01 | $5.86 | Not available in this setting | RVU15A |
| 2014-10-01 | $5.88 | Not available in this setting | RVU14D |
| 2014-07-01 | $5.88 | Not available in this setting | RVU14C |
| 2014-04-01 | $5.88 | Not available in this setting | RVU14B |
| 2014-01-01 | $5.88 | Not available in this setting | RVU14A |
| 2013-10-01 | $5.93 | Not available in this setting | RVU13D |
| 2013-07-01 | $5.93 | Not available in this setting | RVU13C |
| 2013-04-01 | $5.93 | Not available in this setting | RVU13B |
| 2013-01-01 | $5.93 | Not available in this setting | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
97026 billing questions
How does 97026 differ from diathermy?
97026 reports infrared heat, commonly delivered by an infrared lamp. Diathermy is a different modality and is reported with 97024.
Is 97026 a timed service?
No. It is an untimed modality, so units are not counted in 15-minute increments.
Can modifier 26 be appended?
No. CMS identifies 97026 as a therapy service for which the professional-component modifier does not apply.
What documentation supports reporting 97026?
Record the body area treated, the clinical reason for infrared therapy, the modality provided, and how it relates to the therapy plan. Medicare payment is restricted to specific circumstances.
Can 97026 be reported with exercise or another modality?
97026 identifies the infrared application itself, not exercise or another treatment. Report another service only when it was separately furnished and its own reporting requirements are met.
How does the therapy multiple procedure reduction affect 97026?
CMS reduces practice expense for the second and later therapy units furnished on the same day. The reduction applies to practice expense.
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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