CPT 97010: Hot or Cold Pack Application for Therapeutic Treatment
Commercial payers pay $18 on average nationally for this procedure.
CPT code 97010 describes the application of a hot or cold pack to a specific body site as a therapeutic modality to treat injury or disease; the service is typically delivered by a physical therapist or rehabilitation practitioner in an outpatient clinic or rehabilitation setting for localized pain or inflammation management.
For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 97010 centers near BUCA’s average commercial rate of $17.90, but individual payers show meaningful differences in central tendency. Blue Cross Blue Shield pays a notably higher median at $18.20 with a high mean of $18.70, while Cigna’s mean sits at $37.10 driven by a wide spread between lower quartile ($6.40) and upper quartile ($70.20). Aetna and UnitedHealth Group cluster at lower central values, with Aetna’s mean of $5.30 and UnitedHealth Group’s mean of $7.70, indicating lower typical commercial reimbursements for those networks. Dispersion measured by the interquartile range (P75–P25) highlights which payers are tightest or widest: UnitedHealth Group is the tightest with a range of $2.20, and Aetna is also tight at $1.70. Blue Cross Blue Shield shows moderate dispersion of $6.90, BUCA’s interquartile spread is $13.60, and Cigna is the widest by far with a range of $63.80, signaling substantial variability in commercially negotiated rates across plans.