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CMS RVU26D · Effective 2026-10-01

97760 Orthotic training Medicare reimbursement rates in Virginia

Report orthotic management and training for skilled assessment, fitting, adjustment, or instruction in use of an orthosis during an initial encounter. Compare 97760 office and facility rates across CMS payment localities in Virginia.

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 97760 in Virginia?

Virginia 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

$45.50–$52.21

2 of 2 localities have a supported rate.

Lowest: Virginia

Highest: Dc + Md/Va Suburbs

A spread of $6.71 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 97760 in your payment locality →

Rehabilitation therapy

About 97760: Orthotic management and training, initial encounter

Report orthotic management and training for skilled assessment, fitting, adjustment, or instruction in use of an orthosis during an initial encounter.

A physical or occupational therapist typically reports this service while assessing how an orthosis fits and functions, making adjustments, and teaching the patient or caregiver how to apply, remove, or use it. The orthosis may support an upper or lower extremity or the trunk. Common settings include outpatient rehabilitation and hospital therapy departments. Assessment and fitting that are integral to the orthotic management service are included when not separately reported.

Choose this code for an initial orthotic management encounter rather than prosthetic training or a subsequent orthotic management encounter. Document the orthosis and body area, the skilled assessment or adjustments performed, the instruction provided, and the treatment time. The service is timed in 15-minute units. It is a therapy service without separate professional and technical components, so modifier 26 does not apply. When multiple therapy units are furnished on the same day, practice expense is reduced for the second and later units.

CMS billing rules for 97760

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 · 36%
  • Practice expense (office) RVU0.87 · 63%
  • Malpractice RVU0.01 · 1%

57.4K

Medicare services in 2024 · #730 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.

97760 compared with similar codes

Office rates for Virginia, from the same CMS release.

97763

Orthotic/prosthetic care

Subsequent encounter

$49.43–$57.01

97760 represents an initial orthotic management encounter; 97763 represents a subsequent encounter for orthotic management and training.

97761

Prosthetic training

Initial encounter

$39.92–$45.52

Choose 97760 for orthosis management and training. Choose 97761 when the training concerns a prosthesis.

97755

Assistive technology

Face-to-face assessment

$37.36–$41.87

97755 is for assessment of assistive technology needs; 97760 covers skilled management, fitting, adjustment, or use training for an orthosis.

Compare 97760 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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97760 billing questions

How is 97760 different from 97763?

97760 is for an initial orthotic management encounter. Use 97763 for subsequent orthotic management encounters.

When should 97761 be used instead?

Use 97761 for prosthetic training, such as instruction in using a prosthesis. Use 97760 for management and training involving an orthosis.

Can orthotic fitting or assessment be billed separately?

Assessment and fitting integral to the orthotic management service are included when not otherwise reported. Document any distinct service before considering separate reporting.

How are units counted?

The service is timed in 15-minute units. The record should support the skilled orthotic work and the time reported.

Should modifier 26 be appended?

No. This therapy service is not divided into professional and technical components.

What happens when other therapy units are billed on the same day?

Practice expense is reduced for the second and later therapy units furnished that day, including applicable units of this 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 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 97760PPRRVU2026_Oct_nonQPP.csv, line 12,909 (RVU26D)