CPT 97014: Electrical Stimulation for Muscle Reeducation
Commercial payers pay $33 on average nationally for this procedure.
CPT code 97014 describes therapeutic electrical stimulation applied by a clinician, typically a physical therapist, to nerves or muscles to produce muscle contraction aimed at restoring function after disease or trauma; this service is a physical medicine modality used in outpatient or inpatient rehabilitation settings and is commonly delivered in physical therapy clinics or rehabilitation departments.
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
National commercial reimbursement for CPT 97014 centers around an average commercial benchmark from BUCA of $33.00, while individual payer medians and means vary notably. Blue Cross Blue Shield has a high ceiling and a broad spread, Cigna also shows wide dispersion around a relatively high mean, and UnitedHealth Group, Aetna, and BUCA sit lower in central tendency. These differences suggest payer-specific contract variability rather than a single market price.
Measuring dispersion as P75 minus P25 highlights variability: Blue Cross Blue Shield’s dispersion is $24.20 (P75 $48.20 minus P25 $24.00), Cigna’s is $57.20 (P75 $71.50 minus P25 $13.80) and UnitedHealth Group’s is $5.60 (P75 $18.40 minus P25 $12.80). Aetna’s dispersion is $9.40 (P75 $18.40 minus P25 $9.70) and BUCA’s is $24.10 (P75 $43.00 minus P25 $18.90), so Cigna is the widest and UnitedHealth Group the tightest.