CPT code 97161: PT evaluation, low complexity, typically 20 minutes2026 Medicare rate & RVUs in Aromas, California
CPT 97161: $106.63–$123.74 office across 2 localities in Aromas, CA in 2026 Medicare. Compare each area.
Medicare pays $106.63–$123.74 for 97161 in the office in Aromas, California, from Salinas, CA to San Benito County, CA. Which amount applies depends on the service address.
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 6 sections
Where 97161 pays more and less in Aromas, California
Aromas, California maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.
| Payment locality | Office | Facility |
|---|---|---|
| Salinas, CA | $106.63 | Unavailable |
| San Benito County, CA | $123.74 | Unavailable |
How payment areas work in Aromas
City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.
- Monterey · Monterey County
- San Benito · San Benito County
City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions
How the 97161 rate is calculated
Each of 97161’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 · 97161
RVUs × geographic indexes × conversion factor
Work1.54
1.54 RVUs× 1.000 GPCI
Practice expense1.38
1.38 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
2.9300
Conversion factor
$33.4009
Medicare rate
$97.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97161
The CMS indicators that decide how 97161 is paid alongside other services.
CMS payment indicators · 97161
PT evaluation, low complexity, typically 20 minutes
| 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
97161 without CQ · national office
$97.86
PT evaluation, low complexity, typically 20 minutes
97161-CQ · Allowed amount unchanged
$97.86
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.
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 · Coming soon
Put 97161 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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