Billing code 97028: Light therapyMedicare rate & RVUs in Washington
Reports ultraviolet light applied as a therapeutic modality to one or more areas during a documented rehabilitation or treatment session.
Medicare pays $8.59–$9.64 for 97028 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 97028 covers
This code covers therapeutic application of ultraviolet light to one or more treatment areas. Physical therapists and other qualified therapy professionals may use it as a modality within a plan of care, including for a documented skin or tissue condition. The record should identify the treated area, the reason for treatment, and the ultraviolet intervention provided.
Report the service for the ultraviolet modality actually delivered, not for infrared, ultrasound, or another physical agent. It is an untimed modality, so report one unit for the treatment session rather than counting 15-minute increments. Documentation should support the clinical purpose and distinguish the modality from other services furnished that day. CMS treats it as a therapy service without a professional-component modifier split. Under the therapy multiple procedure payment reduction, practice expense is reduced for the second and later therapy units furnished on the same day.
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 97028 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $8.59 | Unavailable |
| Seattle (King Cnty) | $9.64 | Unavailable |
How the 97028 rate is calculated
Each of 97028’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 · 97028
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.08Practice expense 0.16Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 97028
The CMS indicators that decide how 97028 is paid alongside other services.
CMS payment indicators · 97028
Light 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
97028 without CQ · national office
$8.35
Light therapy
97028-CQ · Allowed amount unchanged
$8.35
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.
97028 compared with similar codes
Compare codes
97028 vs 97026 vs 97024 vs 97035: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 97026Infrared therapy
- 97028 is for ultraviolet light; 97026 is for infrared. Choose according to the light modality applied.
- 97024Diathermy
- 97024 represents diathermy, such as microwave treatment, rather than ultraviolet light application.
- 97035Therapeutic ultrasound
- 97035 is therapeutic ultrasound; use 97028 only when ultraviolet light is the modality delivered.
97028 billing questions
How is this different from infrared therapy?
97028 represents ultraviolet application. Use 97026 when infrared is the modality actually delivered.
Is 97028 billed in 15-minute units?
No. It is an untimed modality; report one unit for the treatment session, not units based on elapsed time.
Should modifier 26 be appended?
No. CMS identifies this as a therapy service for which the professional-component modifier does not apply.
What documentation supports the service?
Record the clinical purpose, the area treated, and that ultraviolet light was applied. The documentation should distinguish it from any other modality performed during the visit.
How does the therapy multiple procedure reduction affect payment?
When multiple therapy units are furnished on the same day, CMS reduces practice expense for the second and later units.
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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