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CPT code 97811: Acupuncture, each additional 15 minutes2026 Medicare rate & RVUs in Montana

Report this add-on for each additional 15 minutes of one-on-one acupuncture without electrical stimulation, following the initial acupuncture service.

CMS RVU26DEffective Oct 1, 2026One payment locality98.5K Medicare services in 2024

In Montana, Medicare pays $28.39 for 97811 in the office and $20.71 when it’s performed in a hospital or facility.

$28.39Office (non-facility)
$20.71Hospital or facility
+0.0%vs the national office rate ($28.39)

Check a contract rate as a % of Medicare · 97811 nationwide

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

We’ll open 97811 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 97811 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 97811 covers

This add-on represents an additional 15 minutes of direct, one-on-one acupuncture care without electrical stimulation, including reinsertion of one or more needles. Acupuncturists and other qualified practitioners may provide the service in an office or facility setting. A typical treatment uses needles placed at selected points and manually manipulated; electrical stimulation of the needles belongs to a different code family.

Report 97811 only with the primary acupuncture service 97810, after the initial service, and only for additional qualifying time. Document the practitioner’s face-to-face time and needle reinsertion supporting the additional service. CMS classifies 97811 as an add-on code: it must be billed with a primary procedure and is paid within that procedure’s global period.

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 Montana compares for 97811

Across 109 of 109 payment localities, the office rate for 97811 runs from $26.21 in Arkansas to $36.40 in Alaska. Montana pays $28.39. The RVUs are the same everywhere; the geographic indexes change the dollars.

97811 in Montana vs other payment areas
  1. Montana · this page$28.39
  2. Los Angeles, CA · California$30.88+$2.49
  3. Washington, DC area · District of Columbia$31.47+$3.08
  4. Miami, FL · Florida$30.42+$2.03
  5. Chicago, IL · Illinois$29.86+$1.47
  6. Manhattan, NY · New York$31.91+$3.52
  7. Alaska · Alaska$36.40+$8.01

Other areas in Montana first, then benchmark localities. Bars start at $0.

Every other payment area

97811 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$26.45$19.73
ArkansasArkansas$26.21$19.61
ArizonaArizona$27.87$20.43
Bakersfield, CACalifornia$29.45$21.03
Chico, CACalifornia$29.34$20.92
El Centro, CACalifornia$29.35$20.93
Fresno, CACalifornia$29.34$20.92
Hanford, CACalifornia$29.34$20.92

97811 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$26.21

$36.40

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
97811 office rate range by state
State / territoryOffice rate rangeLocalities
AK$36.401
AL$26.451
AR$26.211
AZ$27.871
CA$29.34–$34.9329
CO$29.131
CT$29.831
DC$31.471
DE$28.221
FL$28.37–$30.423
GA$27.28–$28.832
GU$29.621
HI$29.621
IA$26.761
ID$26.901
IL$27.91–$29.864
IN$27.001
KS$26.741
KY$26.971
LA$26.97–$27.822
MA$29.07–$31.242
MD$28.61–$31.473
ME$27.05–$27.912
MI$27.47–$28.662
MN$28.031
MO$26.71–$27.823
MS$26.461
MT$28.391
NC$27.221
ND$27.801
NE$26.841
NH$28.761
NJ$30.21–$31.352
NM$27.591
NV$28.241
NY$27.49–$32.515
OH$27.351
OK$26.881
OR$28.05–$29.712
PA$27.35–$29.352
PR$28.511
RI$28.971
SC$27.331
SD$27.731
TN$26.831
TX$27.24–$29.008
UT$27.571
VA$27.89–$31.472
VI$28.511
VT$27.781
WA$28.99–$31.712
WI$27.191
WV$27.251
WY$28.131

See 97811 in every payment locality

How the 97811 rate is calculated

Each of 97811’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 · 97811

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.46

0.46 RVUs× 1.000 GPCI

Practice expense0.36

0.36 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

0.8500

Conversion factor

$33.4009

Medicare rate

$28.39

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,917

Code
97811
Physician work
0.46
Practice expense
0.36
Malpractice
0.03

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 97811 in Montana
ComponentRVULocality factorAdjusted
Physician work0.46× 1.0000.4600
Practice expense0.36× 1.0000.3600
Malpractice0.03× 0.9980.0299
Total RVUs0.8499
Conversion factor× 33.4009

Office rate, Montana$28.39

Office: (0.46 × 1 + 0.36 × 1 + 0.03 × 0.998) × $33.4009 = $28.39

Facility: (0.46 × 1 + 0.13 × 1 + 0.03 × 0.998) × $33.4009 = $20.71

Open 97811 in the RVU calculator

Payment rules and modifiers for 97811

The CMS indicators that decide how 97811 is paid alongside other services.

CMS payment indicators · 97811

Acupuncture, each additional 15 minutes

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 97811

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

Codes related to 97811
CodeHow it relatesOffice range, Montana
Add-on codes
97810Acupuncture, without electrical stimulation, initial 15 minutesPrimary code for the initial acupuncture service without electrical stimulation.$48.09
Used instead
97814Acupuncture, additional 15 minutes with stimulationAdditional acupuncture time when electrical stimulation is used.$28.72
97813Acupuncture, with electrical stimulationInitial acupuncture service when electrical stimulation is used.$56.44

How 97811 has changed in Montana

97811 · Office / nonfacility

$28.39

Effective 2026-10-01

The base rate is $2.86 higher than on 2025-10-01, moving from $25.53 to $28.39 (11.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $25.53changed to$28.39

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.30 changed to 0.36
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $28.27changed to$25.53

    • Conversion factor 33.2875 changed to 32.3465
    • Work RVU 0.50 changed to 0.46
    • Practice expense RVU 0.32 changed to 0.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $27.81changed to$28.27

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $29.11changed to$27.81

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.04 changed to 0.03

  5. January 1, 2023

    RVU23A

    $30.08changed to$29.11

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.33 changed to 0.32
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $27.88changed to$30.08

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.26 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $29.42changed to$27.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.25 changed to 0.26
    • Malpractice RVU 0.05 changed to 0.04
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. April 1, 2020

    RVU20B

    No ratechanged to$29.42

    Held through RVU20C, RVU20D.

  9. 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, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$28.39$20.71RVU26D
2026-07-01$28.39$20.71RVU26C
2026-04-01$28.39$20.71RVU26B
2026-01-01$28.39$20.71RVU26A
2025-10-01$25.53$22.94RVU25D
2025-07-01$25.53$22.94RVU25C
2025-04-01$25.53$22.94RVU25B
2025-01-01$25.53$22.94RVU25A
2024-10-01$28.27$25.28RVU24D
2024-07-01$28.27$25.28RVU24C
2024-04-01$28.27$25.28RVU24B
2024-03-09$28.27$25.28RVU24AR
2024-01-01$27.81$24.86RVU24A
2023-10-01$29.11$26.06RVU23D
2023-07-01$29.11$26.06RVU23C
2023-04-01$29.11$26.06RVU23B
2023-01-01$29.11$26.06RVU23A
2022-10-01$30.08$26.96RVU22D
2022-07-01$30.08$26.96RVU22C
2022-04-01$30.08$26.96RVU22B
2022-01-01$30.08$26.96RVU22A
2021-10-01$27.88$25.44RVU21D
2021-07-01$27.88$25.44RVU21C
2021-04-01$27.88$25.44RVU21B
2021-01-01$27.88$25.44RVU21A
2020-10-01$29.42$27.25RVU20D
2020-07-01$29.42$27.25RVU20C
2020-04-01$29.42$27.25RVU20B
2020-01-01Separate payment rules applySeparate payment rules applyRVU20A
2019-10-01Separate payment rules applySeparate payment rules applyRVU19D
2019-07-01Separate payment rules applySeparate payment rules applyRVU19C
2019-04-01Separate payment rules applySeparate payment rules applyRVU19B
2019-01-01Separate payment rules applySeparate payment rules applyRVU19A
2018-10-01Separate payment rules applySeparate payment rules applyRVU18D
2018-07-01Separate payment rules applySeparate payment rules applyRVU18C
2018-04-01Separate payment rules applySeparate payment rules applyRVU18B
2018-01-01Separate payment rules applySeparate payment rules applyRVU18AR1
2017-10-01Separate payment rules applySeparate payment rules applyRVU17D
2017-07-01Separate payment rules applySeparate payment rules applyRVU17C
2017-04-01Separate payment rules applySeparate payment rules applyRVU17B
2017-01-01Separate payment rules applySeparate payment rules applyRVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Separate payment rules applySeparate payment rules applyRVU13D
2013-07-01Separate payment rules applySeparate payment rules applyRVU13C
2013-04-01Separate payment rules applySeparate payment rules applyRVU13B
2013-01-01Separate payment rules applySeparate payment rules applyRVU13AR

Price 97811 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

97811 billing questions

Can 97811 be reported by itself?

No. It is an add-on code and must be reported with the primary acupuncture service, 97810.

How does 97811 differ from 97810?

97810 represents the initial 15 minutes of acupuncture without electrical stimulation. 97811 represents each additional 15 minutes after that initial service.

What documentation supports 97811?

Document the additional one-on-one time and needle reinsertion supporting the service, along with the acupuncture treatment provided.

When should 97814 be used instead?

Use 97814 for additional acupuncture time when electrical stimulation is applied to the needles. Code 97811 is for treatment without electrical stimulation.

How does the CMS add-on rule affect payment?

CMS requires 97811 to be billed with a primary procedure and pays it within that procedure’s global period.

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
RVUs for 97811PPRRVU2026_Oct_nonQPP.csv, line 12,917 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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