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Billing code 97018: Paraffin therapyMedicare rate & RVUs

Paraffin bath therapy applies therapeutic heat, commonly to a hand or wrist, as a physical or occupational therapy modality.

CMS RVU26DEffective Oct 1, 2026109 payment localities160.8K Medicare services in 2024

Medicare pays $6.01 for 97018 nationally in the office. Local office rates run $5.33–$7.70.

Medicare rate · 97018

Paraffin therapy

Swap in your local Medicare rate.

Work RVUs
0.06
Total RVUs
0.18
Global days
XXX

National rate · 2026

$6.01

Office setting, before claim adjustments.

See every locality for 97018 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 97018 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 97018 covers

Paraffin bath therapy uses warmed paraffin wax to deliver superficial heat to a body area. Physical and occupational therapists commonly use it for a hand or wrist affected by stiffness or pain, often before therapeutic movement or hand-function activities. The patient immerses the area in the wax or has wax applied, and the therapist manages the treatment and monitors the area.

Report 97018 for the paraffin modality itself, not for exercise or other skilled treatment performed during the visit. Documentation should identify the treated area, the clinical reason for heat, and the treatment provided. This is a therapy service, so a professional-component modifier does not apply. When multiple therapy units are reported for the same patient on the same day, CMS reduces practice expense for the second and later units.

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 97018 pays more and less

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

109 payment localities

$5.33 to $7.70

$5.33$6.52$7.70
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

97018 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$5.41Unavailable
Alaska*$7.10Unavailable
Arizona$5.85Unavailable
Arkansas$5.33Unavailable
Atlanta$6.14Unavailable
Austin$6.19Unavailable
Bakersfield$6.27Unavailable
Baltimore/Surr. Cntys$6.39Unavailable
Beaumont$5.66Unavailable
Brazoria$5.92Unavailable

97018 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.

$5.33

$7.10

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

View every state and territory as a table
97018 office rate range by state
State / territoryOffice rate rangeLocalities
AK$7.101
AL$5.411
AR$5.331
AZ$5.851
CA$6.24–$7.7029
CO$6.201
CT$6.411
DC$6.811
DE$5.941
FL$6.02–$6.673
GA$5.68–$6.142
GU$6.371
HI$6.371
IA$5.501
ID$5.541
IL$5.88–$6.484
IN$5.571
KS$5.491
KY$5.581
LA$5.58–$5.842
MA$6.17–$6.772
MD$6.05–$6.813
ME$5.59–$5.862
MI$5.74–$6.112
MN$5.881
MO$5.50–$5.843
MS$5.411
MT$6.011
NC$5.651
ND$5.811
NE$5.521
NH$6.121
NJ$6.46–$6.752
NM$5.771
NV$5.961
NY$5.73–$7.125
OH$5.701
OK$5.541
OR$5.90–$6.372
PA$5.69–$6.262
PR$6.051
RI$6.141
SC$5.681
SD$5.791
TN$5.521
TX$5.66–$6.198
UT$5.761
VA$5.85–$6.812
VI$6.051
VT$5.811
WA$6.15–$6.892
WI$5.631
WV$5.671
WY$5.931

How the 97018 rate is calculated

Each of 97018’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 · 97018

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.06Practice expense 0.11Malpractice 0.01

0.1800 adjusted RVUs×$33.4009 conversion factor=$6.01

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 97018

The CMS indicators that decide how 97018 is paid alongside other services.

CMS payment indicators · 97018

Paraffin therapy

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures5Therapy reduction: practice expense of the second and later units is reduced.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

97018 without CQ · national office

$6.01

Paraffin therapy

97018-CQ · Allowed amount unchanged

$6.01

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.

97018 compared with similar codes

Compare codes

97018 vs 97010 vs 97022 vs 97034: national Medicare rates

Swap in your local Medicare rate.

  • 97018
    Paraffin therapy · 0.06 wRVU
    $6.01
  • 97010
    · 0.06 wRVU
    —
  • 97022
    Whirlpool therapy · 0.17 wRVU
    $15.70+$9.69
  • 97034
    Contrast baths · 0.21 wRVU
    $14.03+$8.02

How to choose

97010Hot or cold packs therapy
Choose 97018 when warmed paraffin wax is applied. Choose 97010 when the treatment uses hot or cold packs.
97022Whirlpool therapy
97018 describes paraffin wax heat; 97022 describes whirlpool treatment using water immersion.
97034Contrast baths
97034 is for contrast bath treatment alternating warm and cold immersion. 97018 is for paraffin bath therapy.

Codes related to 97018

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

Codes related to 97018
CodeHow it relatesNational office range
Used instead
97010Hot or cold packs therapyHot or cold packs are a different method of applying a thermal modality.No office rate
97022Whirlpool therapyWhirlpool uses water immersion rather than warmed paraffin wax.$14.17–$20.45
97034Contrast bathsContrast baths alternate warm and cold immersion and are reported as a timed modality.$12.92–$17.82
Often billed with
97110Therapeutic exerciseTherapeutic exercise may be separately provided during the same therapy encounter.$26.97–$37.31

97018 billing questions

When should 97018 be chosen over hot or cold packs?

Use 97018 when paraffin wax is the heat-delivery method. Hot or cold packs are reported with 97010 when packs, rather than a paraffin bath, provide the modality.

Is 97018 reported per 15 minutes?

The code represents paraffin bath therapy and is not a 15-minute timed modality code. Do not calculate units from the timed structure used by codes such as 97034.

Can therapeutic exercise be reported in the same visit?

Yes, when the therapist separately provides and documents skilled therapeutic exercise. The paraffin modality alone does not describe that exercise.

Should modifier 26 be appended?

No. CMS identifies 97018 as a therapy service for which the professional-component modifier does not apply.

What documentation supports reporting 97018?

Record the treated body area, the condition or functional problem prompting heat, and that paraffin therapy was administered. Document separately any distinct skilled treatment performed during the encounter.

How does the therapy multiple procedure reduction affect 97018?

When multiple therapy units are reported on the same day, CMS reduces practice expense for the second and later units. The reduction concerns practice expense, not a change in the service documented.

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 97018PPRRVU2026_Oct_nonQPP.csv, line 12,847 (RVU26D)

Open CMS sourceHow we calculate rates

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