CPT code 97039: Unlisted modality2026 Medicare rate & RVUs in Illinois
Reports a therapeutic physical modality without its own listed CPT code when a therapist provides a treatment not represented by a specific modality code.
CMS doesn’t publish an office rate for 97039 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 97039 covers
A physical therapist or other qualified therapy professional reports 97039 for a therapeutic modality that does not have its own specific CPT modality code. Identify the modality and describe the treatment so the service can be distinguished from listed methods such as traction, electrical stimulation, or ultrasound. This code is for an unlisted modality, not a substitute for a listed code that accurately describes the treatment provided.
Medicare assigns 97039 carrier-priced status (status C): CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The code is a therapy service, and the professional component modifier does not apply. The code does not set a per-15-minute unit; when the modality involves constant attendance, specify the modality and treatment time.
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.
Where 97039 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | Unavailable |
| East St. Louis, IL | Unavailable | Unavailable |
| Rest of Illinois | Unavailable | Unavailable |
| Suburban Chicago, IL | Unavailable | Unavailable |
How the 97039 rate is calculated
Each of 97039’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 · 97039
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97039
The CMS indicators that decide how 97039 is paid alongside other services.
CMS payment indicators · 97039
Unlisted modality
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
97039 without CQ · national facility
$0.00
Unlisted modality
97039-CQ · Allowed amount unchanged
$0.00
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.
97039 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 97010Pack therapyHot or cold
- 97010 identifies hot- or cold-pack therapy. Use 97039 only when the modality provided lacks its own specific code.
- 97012Mechanical tractionDevice-applied therapy
- 97012 identifies mechanical traction. A different, unlisted modality may be reported with 97039.
- 97032Electrical stimulationAttended, timed modality
- 97032 describes attended electrical stimulation. Do not use 97039 when electrical stimulation is the treatment represented by 97032.
- 97035Therapeutic ultrasoundConstant attendance, each 15 minutes
- 97035 identifies ultrasound therapy. Use 97039 for a modality not specifically represented by a listed code, rather than for ultrasound.
97039 billing questions
When should a therapist use 97039 instead of a listed modality code?
Use 97039 when the delivered therapeutic modality has no specific CPT modality code. Use a listed code when it describes the method provided, such as electrical stimulation or ultrasound.
What should the claim identify for 97039?
Identify the modality and describe the treatment. If it involves constant attendance, specify the treatment time as well.
Is 97039 billed in 15-minute units?
The code does not establish a per-15-minute unit. Specify the time when reporting a constant-attendance modality.
Should modifier 26 be appended?
No. The professional component modifier does not apply to this therapy service.
How does Medicare price 97039?
It has carrier-priced status (status C), so CMS publishes no national payment and the Medicare Administrative Contractor sets payment for each claim.
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
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