CPT code 97763: Orthotic/prosthetic care, subsequent encounter2026 Medicare rate & RVUs

Medicare pays $50.10 for 97763 nationally in the office. Local office rates run $45.18–$66.62.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 97763 covers

A therapist or other qualified practitioner uses this service at a follow-up visit to assess and manage an orthosis or prosthesis, address fit or function, make appropriate adjustments, and train the patient in use. Examples include follow-up instruction in using a brace or prosthetic limb and reassessment of how the device is working during daily activities. The service is commonly furnished in outpatient rehabilitation or a practitioner’s office.

Choose 97763 for a subsequent encounter rather than the initial orthotic or prosthetic service; report it in 15-minute units. Document the device, the skilled management or training performed, the patient’s response, and the timed service. This therapy service is not divided into professional and technical components, so modifier 26 is not appropriate. CMS reduces practice expense for the second and later therapy units furnished on the same day.

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 97763 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

97763 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 97763 rate is calculated

Each of 97763’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.

Payment rules and modifiers for 97763

The CMS indicators that decide how 97763 is paid alongside other services.

What modifiers do to the payment

97763 compared with similar codes

How to choose

97760Orthotic trainingInitial encounter

Use 97760 for the initial orthotic management and training encounter. Use 97763 for subsequent orthotic or prosthetic management and training.

97761Prosthetic trainingInitial encounter

97761 covers initial prosthetic training; 97763 covers subsequent management or training involving an orthosis or prosthesis.

97750Performance testTimed testing with written report

97750 reports a physical performance test. Choose 97763 when the service is follow-up management or training for an orthosis or prosthesis.

97755Assistive technologyFace-to-face assessment

97755 is an assistive technology assessment. Use 97763 for subsequent management or training involving an orthosis or prosthesis.

Codes related to 97763

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates