Therapeutic ultrasound applied to one or more areas with the clinician present, billed in 15-minute units.
- Medicare
- $14.36
- Work RVU
- 0.21
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Area treated
- Frequency, intensity, and duty cycle
- Minutes of direct contact
- Diagnosis and reason for ultrasound
- Patient response and link to goals
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
97035 is therapeutic ultrasound, a timed modality where the clinician moves the transducer over the tissue. Each unit is 15 minutes of direct contact.
Ortho PT uses it for tendinopathy, bursitis, and soft tissue healing at the shoulder, elbow, and knee. Real treatment times are often 5 to 8 minutes, which means one unit of ultrasound frequently depends on combining minutes with other timed codes under the Medicare 8-minute rule. Billing a full unit for 6 minutes of ultrasound alone, with no other timed services, is wrong.
Payer scrutiny is high. Several commercial plans consider therapeutic ultrasound of unproven benefit for many conditions and deny it, and others limit visits. Document the area, frequency (MHz), intensity, duty cycle, time, and why ultrasound was chosen. This is not diagnostic ultrasound; imaging uses the 76xxx range. Use GP or GO on Medicare claims.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.21) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (0.43) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.21 |
| Practice expense RVU | 0.21 |
| Malpractice RVU | 0.01 |
| Total RVU | 0.43 |
| Medicare national rate | $14.36 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $14.36 |
Common denial reasons
The recurring reasons claims for CPT 97035 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Payer policy considers therapeutic ultrasound unproven for the diagnosis
- Units billed for under 8 minutes with no other timed codes
- Missing therapy modifier
- Parameters not documented
- Billed as diagnostic imaging
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can I bill 97035 for 6 minutes of ultrasound?
02Is 97035 diagnostic ultrasound?
03Why do commercial payers deny 97035?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the area, settings, and treatment minutes in the note, which is what payers check when they question ultrasound.
See how Mira captures CPT 97035 documentation