Billing code 97016: Vasopneumatic therapyMedicare rate & RVUs in Alaska
Report supervised vasopneumatic compression therapy for swelling after injury or surgery, or for lymphedema, when a device applies cyclic pressure.
Medicare pays $15.25 for 97016 in the office in Alaska (Alaska*). 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 9 sections
What 97016 covers
A vasopneumatic device inflates and deflates a sleeve, boot, or wrap around a limb or joint to apply cyclic pressure to swollen tissue. Some devices also circulate cold fluid. Physical and occupational therapists, and assistants working under them, use the treatment in outpatient rehabilitation for postoperative knee swelling, ankle sprains, or arm or leg lymphedema. The clinician sets up and supervises the modality but need not remain one-on-one throughout the treatment.
Report one untimed unit per date of service, even if the device treats more than one area or runs for a longer period. The record should identify the treated area, duration, relevant device settings when available, the swelling and its functional effects, and the patient's response under the therapy plan of care. Objective measurements can help demonstrate progress but are not required at every session. A professional component modifier is not used for this therapy service. When multiple therapy units are furnished on the same day, Medicare reduces practice expense payment 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.
97016 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $15.25 | Unavailable |
How the 97016 rate is calculated
Each of 97016’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 · 97016
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.18Practice expense 0.17Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 97016
The CMS indicators that decide how 97016 is paid alongside other services.
CMS payment indicators · 97016
Vasopneumatic therapy
| 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
97016 without CQ · national office
$12.02
Vasopneumatic therapy
97016-CQ · Allowed amount unchanged
$12.02
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.
97016 compared with similar codes
Compare codes
97016 vs 97010 vs 97140 vs 97014 vs 97035: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 97010Hot or cold packs therapy
- Hot or cold packs provide thermal treatment without cycling pressure. Use 97016 when a vasopneumatic device applies cyclic compression, whether or not it also delivers cold.
- 97140Manual therapy
- Manual lymphatic drainage is hands-on manual therapy billed in 15-minute units. Vasopneumatic therapy uses a compression device and is reported as one untimed unit per date of service.
- 97014Electric stimulation therapy
- Unattended electrical stimulation delivers current through electrodes; vasopneumatic therapy delivers cyclic pressure through a sleeve or wrap. Both are supervised, untimed modalities.
- 97035Therapeutic ultrasound
- Ultrasound requires constant attendance and is billed in 15-minute units. Vasopneumatic therapy is supervised and reported as one untimed unit per date of service.
97016 billing questions
How many units can be billed for vasopneumatic treatment?
Report one unit per date of service. A longer application or treatment of multiple areas does not increase the unit count.
Can cold packs be billed separately when the vasopneumatic device also delivers cold?
Do not separately report a cold pack for cold delivered as part of the vasopneumatic device treatment.
Does the therapist need to stay with the patient the entire time?
No. Vasopneumatic therapy is a supervised modality; it does not require the constant one-on-one attendance required for timed modalities such as ultrasound.
Which therapy modifier goes on this code?
Use GP for treatment under a physical therapy plan of care or GO under an occupational therapy plan of care. Do not use a professional component modifier.
Can a home pneumatic compression pump be billed with this code?
No. This code reports supervised outpatient treatment, not a pump or sleeve supplied for home use as durable medical equipment.
What documentation supports medical necessity?
Document the cause and extent of swelling, its effect on function, the area treated, treatment duration, and the patient's response. Girth or volume measurements can help show progress over the course of care.
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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