# CPT 97162

> Medicare paid $101.89 for CPT 97162 in the office (non-facility) setting and $101.89 in a facility under the Q3 2021 Physician Fee Schedule, effective July 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it increased 16.2%.

## What it is

The middle of the three initial physical therapy evaluation levels. It fits a patient whose history includes other conditions or personal factors that complicate the plan, whose examination covers several body systems or sets of measurements, and whose presentation is changing enough to need genuine clinical judgement. Against the low-complexity level it involves more data gathering and a less predictable case; against the high-complexity level the patient is still comparatively stable.

## Selected release

- Release: Q3 2021 (2021 C)
- Effective: July 1 – September 30, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $101.89
- Facility national allowed amount: $101.89
- Sequestration: not applied

## RVUs and formula

- Work RVU: 1.54
- Office (non-facility) practice expense RVU: 1.33
- Facility practice expense RVU: 1.33
- Malpractice RVU: 0.05
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q3 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21c-updated-6302021.zip
- Parsed file: PPRRVU21_JUL.csv, row 17,120
- Canonical page: https://localishealth.com/cpt/97162/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/97162/2021/C
- Last significant update: 2026-08-04T03:10:45+00:00