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CMS RVU26D · Effective 2026-10-01

97761 Prosthetic training Medicare reimbursement rates in Maine

Reports initial skilled training to use an upper- or lower-extremity prosthesis, including instruction in safe use and functional activities. Compare 97761 office and facility rates across CMS payment localities in Maine.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 97761 in Maine?

Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$38.42–$40.08

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $1.66 per service.

Facility setting

No supported rate

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 97761 in your payment locality →

Physical therapy

About 97761: Initial prosthetic use training

Reports initial skilled training to use an upper- or lower-extremity prosthesis, including instruction in safe use and functional activities.

A physical or occupational therapist typically provides this training after a patient receives an upper- or lower-extremity prosthesis. Treatment may address putting on and removing the device, operating its components, safety, and using it during functional activities such as standing or walking. The service is directed at learning to use the prosthesis, rather than general exercise or a device assessment alone.

Report 97761 for the initial prosthetic-training encounter, in 15-minute units. Documentation should identify the prosthesis, skilled training performed, treatment time, the patient’s response, and progress toward functional goals. This is a therapy service, so a professional-component modifier does not apply. Under the CMS therapy multiple procedure payment reduction, practice expense is reduced for the second and later therapy units furnished on the same day.

CMS billing rules for 97761

Professional and technical components
Therapy service: the professional component modifier does not apply.
Multiple procedures
Therapy multiple procedure payment reduction: practice expense is reduced for the second and later therapy units on the same day.

Where the value comes from

  • Work RVU0.50 · 41%
  • Practice expense (office) RVU0.70 · 58%
  • Malpractice RVU0.01 · 1%

3.8K

Medicare services in 2024 · #2022 by national volume

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.

97761 compared with similar codes

Office rates for Maine, from the same CMS release.

97760

Orthotic training

Initial encounter

$43.64–$45.71

97760 addresses initial training for an orthosis, while 97761 addresses training to use a prosthesis.

97763

Orthotic/prosthetic care

Subsequent encounter

$47.28–$49.67

97763 is for subsequent orthotic or prosthetic management and training encounters; 97761 is for the initial prosthetic-training encounter.

97116

Gait training

Each 15 minutes, one-on-one

$27.84–$28.81

97116 covers gait training. Choose 97761 for skilled instruction in using the prosthesis; report both only when each service is distinct.

97750

Performance test

Timed testing with written report

$32.14–$33.45

97750 is a physical performance test, not hands-on instruction in using a prosthesis.

Compare 97761 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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97761 billing questions

When should 97761 be used instead of 97763?

Use 97761 for the initial prosthetic-training encounter. Use 97763 for subsequent orthotic or prosthetic management and training encounters.

Is 97761 reported in timed units?

Yes. The code is reported in 15-minute units, with documentation supporting the skilled treatment time.

Can a professional-component modifier be appended?

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

Can 97761 be reported with gait training?

It may be reported with 97116 when the therapist performs distinct gait-training work in addition to prosthesis-use training and documents each service.

What documentation supports 97761?

Document the prosthesis, the specific instruction or functional practice provided, treatment time, the patient’s response, and progress toward goals.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 97761PPRRVU2026_Oct_nonQPP.csv, line 12,910 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet