CPT code 97763: Orthotic/prosthetic care, subsequent encounter2026 Medicare rate & RVUs in New Mexico
Report 97763 for timed follow-up management or training involving an orthosis or prosthesis after the initial encounter.
In New Mexico, Medicare pays $47.37 for 97763 in the office.
Check a contract rate as a % of Medicare · 97763 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 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.
How New Mexico compares for 97763
Across 109 of 109 payment localities, the office rate for 97763 runs from $45.18 in Arkansas to $66.62 in San Benito County, CA. New Mexico pays $47.37. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$47.37
- Los Angeles, CA · California$56.82+$9.45
- Washington, DC area · District of Columbia$57.01+$9.64
- Miami, FL · Florida$52.00+$4.63
- Chicago, IL · Illinois$50.81+$3.44
- Manhattan, NY · New York$56.79+$9.42
- Alaska · Alaska$60.16+$12.79
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $45.74 | — |
| ArkansasArkansas | $45.18 | — |
| ArizonaArizona | $49.01 | — |
| Bakersfield, CACalifornia | $53.51 | — |
| Chico, CACalifornia | $53.46 | — |
| El Centro, CACalifornia | $53.46 | — |
| Fresno, CACalifornia | $53.46 | — |
| Hanford, CACalifornia | $53.46 | — |
| Madera, CACalifornia | $53.46 | — |
| Merced, CACalifornia | $53.46 | — |
| Modesto, CACalifornia | $53.46 | — |
| Napa, CACalifornia | $61.67 | — |
| Oxnard, CACalifornia | $56.56 | — |
| Redding, CACalifornia | $53.46 | — |
| Rest of CaliforniaCalifornia | $53.46 | — |
| Riverside, CACalifornia | $53.58 | — |
| Sacramento, CACalifornia | $56.02 | — |
| Salinas, CACalifornia | $55.81 | — |
| San Diego, CACalifornia | $57.04 | — |
| Marin County, CACalifornia | $65.28 | — |
| San Francisco, CACalifornia | $65.26 | — |
| San Benito County, CACalifornia | $66.62 | — |
| Santa Clara County, CACalifornia | $66.57 | — |
| San Luis Obispo, CACalifornia | $54.91 | — |
| Santa Cruz, CACalifornia | $57.54 | — |
| Santa Maria, CACalifornia | $56.00 | — |
| Santa Rosa, CACalifornia | $58.12 | — |
| Stockton, CACalifornia | $53.46 | — |
| Vallejo, CACalifornia | $61.66 | — |
| Visalia, CACalifornia | $53.46 | — |
| Yuba City, CACalifornia | $53.46 | — |
| ColoradoColorado | $52.38 | — |
| ConnecticutConnecticut | $53.09 | — |
| DelawareDelaware | $49.74 | — |
| Fort Lauderdale, FLFlorida | $50.81 | — |
| Rest of FloridaFlorida | $48.79 | — |
| Atlanta, GAGeorgia | $50.76 | — |
| Rest of GeorgiaGeorgia | $46.52 | — |
| Hawaii, Guam, HIHawaii | $54.58 | — |
| IowaIowa | $47.03 | — |
| IdahoIdaho | $47.23 | — |
| East St. Louis, ILIllinois | $47.74 | — |
| Rest of IllinoisIllinois | $47.35 | — |
| Suburban Chicago, ILIllinois | $51.38 | — |
| IndianaIndiana | $47.47 | — |
| KansasKansas | $46.70 | — |
| KentuckyKentucky | $46.33 | — |
| New Orleans, LALouisiana | $48.16 | — |
| Rest of LouisianaLouisiana | $46.21 | — |
| Metropolitan Boston, MAMassachusetts | $57.27 | — |
| Rest of MassachusettsMassachusetts | $52.08 | — |
| Baltimore area, MDMaryland | $52.90 | — |
| Rest of MarylandMaryland | $50.64 | — |
| Rest of MaineMaine | $47.28 | — |
| Southern Maine, MEMaine | $49.67 | — |
| Detroit, MIMichigan | $49.15 | — |
| Rest of MichiganMichigan | $47.21 | — |
| MinnesotaMinnesota | $50.84 | — |
| Metropolitan Kansas City, MOMissouri | $48.04 | — |
| Metropolitan St. Louis, MOMissouri | $48.48 | — |
| Rest of MissouriMissouri | $45.44 | — |
| MississippiMississippi | $45.33 | — |
| MontanaMontana | $50.10 | — |
| North CarolinaNorth Carolina | $47.72 | — |
| North DakotaNorth Dakota | $49.90 | — |
| NebraskaNebraska | $47.30 | — |
| New HampshireNew Hampshire | $51.44 | — |
| Northern New JerseyNew Jersey | $56.53 | — |
| Rest of New JerseyNew Jersey | $53.88 | — |
| NevadaNevada | $50.08 | — |
| NYC suburbs and Long Island, NYNew York | $57.79 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $54.10 | — |
| Queens, NYNew York | $57.41 | — |
| Rest of New YorkNew York | $48.32 | — |
| OhioOhio | $47.17 | — |
| OklahomaOklahoma | $46.42 | — |
| Portland, OROregon | $54.02 | — |
| Rest of OregonOregon | $49.87 | — |
| Metropolitan Philadelphia, PAPennsylvania | $51.84 | — |
| Rest of PennsylvaniaPennsylvania | $47.32 | — |
| Puerto RicoPuerto Rico | $50.47 | — |
| Rhode IslandRhode Island | $51.48 | — |
| South CarolinaSouth Carolina | $47.49 | — |
| South DakotaSouth Dakota | $49.88 | — |
| TennesseeTennessee | $46.88 | — |
| Austin, TXTexas | $52.05 | — |
| Beaumont, TXTexas | $47.04 | — |
| Brazoria, TXTexas | $49.85 | — |
| Dallas, TXTexas | $50.06 | — |
| Fort Worth, TXTexas | $49.73 | — |
| Galveston, TXTexas | $49.94 | — |
| Houston, TXTexas | $50.12 | — |
| Rest of TexasTexas | $48.35 | — |
| UtahUtah | $48.04 | — |
| VirginiaVirginia | $49.43 | — |
| Virgin Islands, VIUnited States Virgin Islands | $50.47 | — |
| VermontVermont | $49.60 | — |
| Rest of WashingtonWashington | $52.02 | — |
| King County, WAWashington | $58.50 | — |
| WisconsinWisconsin | $48.45 | — |
| West VirginiaWest Virginia | $45.83 | — |
| WyomingWyoming | $50.01 | — |
97763 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.
$45.18
$60.16
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 | $60.16 | 1 |
| AL | $45.74 | 1 |
| AR | $45.18 | 1 |
| AZ | $49.01 | 1 |
| CA | $53.46–$66.62 | 29 |
| CO | $52.38 | 1 |
| CT | $53.09 | 1 |
| DC | $57.01 | 1 |
| DE | $49.74 | 1 |
| FL | $48.79–$52.00 | 3 |
| GA | $46.52–$50.76 | 2 |
| GU | $54.58 | 1 |
| HI | $54.58 | 1 |
| IA | $47.03 | 1 |
| ID | $47.23 | 1 |
| IL | $47.35–$51.38 | 4 |
| IN | $47.47 | 1 |
| KS | $46.70 | 1 |
| KY | $46.33 | 1 |
| LA | $46.21–$48.16 | 2 |
| MA | $52.08–$57.27 | 2 |
| MD | $50.64–$57.01 | 3 |
| ME | $47.28–$49.67 | 2 |
| MI | $47.21–$49.15 | 2 |
| MN | $50.84 | 1 |
| MO | $45.44–$48.48 | 3 |
| MS | $45.33 | 1 |
| MT | $50.10 | 1 |
| NC | $47.72 | 1 |
| ND | $49.90 | 1 |
| NE | $47.30 | 1 |
| NH | $51.44 | 1 |
| NJ | $53.88–$56.53 | 2 |
| NM | $47.37 | 1 |
| NV | $50.08 | 1 |
| NY | $48.32–$57.79 | 5 |
| OH | $47.17 | 1 |
| OK | $46.42 | 1 |
| OR | $49.87–$54.02 | 2 |
| PA | $47.32–$51.84 | 2 |
| PR | $50.47 | 1 |
| RI | $51.48 | 1 |
| SC | $47.49 | 1 |
| SD | $49.88 | 1 |
| TN | $46.88 | 1 |
| TX | $47.04–$52.05 | 8 |
| UT | $48.04 | 1 |
| VA | $49.43–$57.01 | 2 |
| VI | $50.47 | 1 |
| VT | $49.60 | 1 |
| WA | $52.02–$58.50 | 2 |
| WI | $48.45 | 1 |
| WV | $45.83 | 1 |
| WY | $50.01 | 1 |
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.
How the rate is built · 97763
RVUs × geographic indexes × conversion factor
Work0.48
0.48 RVUs× 1.000 GPCI
Practice expense1.01
1.01 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.5000
Conversion factor
$33.4009
Medicare rate
$50.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,911
- Code
- 97763
- Physician work
- 0.48
- Practice expense
- 1.01
- Malpractice
- 0.01
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.48 | × 1.000 | 0.4800 |
| Practice expense | 1.01 | × 0.917 | 0.9262 |
| Malpractice | 0.01 | × 1.201 | 0.0120 |
| Total RVUs | 1.4182 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$47.37
Office: (0.48 × 1 + 1.01 × 0.917 + 0.01 × 1.201) × $33.4009 = $47.37
Payment rules and modifiers for 97763
The CMS indicators that decide how 97763 is paid alongside other services.
CMS payment indicators · 97763
Orthotic/prosthetic care, subsequent encounter
| 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
97763 without CQ · national office
$50.10
Orthotic/prosthetic care, subsequent encounter
97763-CQ · Allowed amount unchanged
$50.10
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 97763 has changed in New Mexico
97763 · Office / nonfacility
$47.37
Effective 2026-10-01
The base rate is $0.33 higher than on 2025-10-01, moving from $47.04 to $47.37 (0.7%).
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
$47.04changed to$47.37
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.06 changed to 1.01
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$49.01changed to$47.04
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.08 changed to 1.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$48.21changed to$49.01
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$50.28changed to$48.21
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.10 changed to 1.08
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$51.53changed to$50.28
- Conversion factor 34.6062 changed to 33.8872
- Malpractice RVU 0.02 changed to 0.01
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$51.33changed to$51.53
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.08 changed to 1.10
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$50.96changed to$51.33
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.00 changed to 1.08
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$49.07changed to$50.96
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.93 changed to 1.00
- Practice expense GPCI 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$47.02changed to$49.07
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.87 changed to 0.93
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
No ratechanged to$47.02
Held through RVU18B, RVU18C, RVU18D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $47.37 | Not available in this setting | RVU26D |
| 2026-07-01 | $47.37 | Not available in this setting | RVU26C |
| 2026-04-01 | $47.37 | Not available in this setting | RVU26B |
| 2026-01-01 | $47.37 | Not available in this setting | RVU26A |
| 2025-10-01 | $47.04 | Not available in this setting | RVU25D |
| 2025-07-01 | $47.04 | Not available in this setting | RVU25C |
| 2025-04-01 | $47.04 | Not available in this setting | RVU25B |
| 2025-01-01 | $47.04 | Not available in this setting | RVU25A |
| 2024-10-01 | $49.01 | Not available in this setting | RVU24D |
| 2024-07-01 | $49.01 | Not available in this setting | RVU24C |
| 2024-04-01 | $49.01 | Not available in this setting | RVU24B |
| 2024-03-09 | $49.01 | Not available in this setting | RVU24AR |
| 2024-01-01 | $48.21 | Not available in this setting | RVU24A |
| 2023-10-01 | $50.28 | Not available in this setting | RVU23D |
| 2023-07-01 | $50.28 | Not available in this setting | RVU23C |
| 2023-04-01 | $50.28 | Not available in this setting | RVU23B |
| 2023-01-01 | $50.28 | Not available in this setting | RVU23A |
| 2022-10-01 | $51.53 | Not available in this setting | RVU22D |
| 2022-07-01 | $51.53 | Not available in this setting | RVU22C |
| 2022-04-01 | $51.53 | Not available in this setting | RVU22B |
| 2022-01-01 | $51.53 | Not available in this setting | RVU22A |
| 2021-10-01 | $51.33 | Not available in this setting | RVU21D |
| 2021-07-01 | $51.33 | Not available in this setting | RVU21C |
| 2021-04-01 | $51.33 | Not available in this setting | RVU21B |
| 2021-01-01 | $51.33 | Not available in this setting | RVU21A |
| 2020-10-01 | $50.96 | Not available in this setting | RVU20D |
| 2020-07-01 | $50.96 | Not available in this setting | RVU20C |
| 2020-04-01 | $50.96 | Not available in this setting | RVU20B |
| 2020-01-01 | $50.96 | Not available in this setting | RVU20A |
| 2019-10-01 | $49.07 | Not available in this setting | RVU19D |
| 2019-07-01 | $49.07 | Not available in this setting | RVU19C |
| 2019-04-01 | $49.07 | Not available in this setting | RVU19B |
| 2019-01-01 | $49.07 | Not available in this setting | RVU19A |
| 2018-10-01 | $47.02 | Not available in this setting | RVU18D |
| 2018-07-01 | $47.02 | Not available in this setting | RVU18C |
| 2018-04-01 | $47.02 | Not available in this setting | RVU18B |
| 2018-01-01 | $47.02 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
97763 billing questions
How does 97763 differ from 97760 and 97761?
97763 is for subsequent orthotic or prosthetic management and training. 97760 is the initial orthotic management service, while 97761 is initial prosthetic training.
How many units should be reported?
The code is reported in 15-minute units. Document the timed service and the management or training performed at the visit.
Can modifier 26 be appended?
No. This therapy service is not split into professional and technical components, so modifier 26 is not appropriate.
What happens to payment for multiple therapy units on the same day?
CMS reduces the practice expense for the second and each later therapy unit furnished that day.
What documentation supports a subsequent encounter?
Record the orthosis or prosthesis addressed, the follow-up assessment or training provided, the patient's response, and the timed service.
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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