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CPT 97139: Therapeutic Procedure, Unlisted
CPT code 97139 represents unlisted or miscellaneous therapeutic procedures used to bill individualized therapeutic interventions that lack a more specific CPT code. This code matters nationally because it provides a billing pathway for novel, atypical, or uniquely tailored therapeutic services delivered in outpatient rehabilitation and ambulatory therapy settings when no dedicated code exists. Payers rely on documentation to justify use of 97139, and it is relevant to clinicians, billing staff, and payers managing rehabilitative care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical context, typical sites of service, and how 97139 relates to other therapeutic procedure codes used in rehabilitation. The publication summarizes common use cases for reporting unlisted therapeutic procedures, highlights related CPT entries such as 97150, 97530, and 97535, and outlines the practical information billing teams need to code services that do not match a specific procedure code. Where available, benchmarking and policy considerations for national payers are noted. Data not available in the input is explicitly identified when applicable.
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Billing Code Overview
CPT code 97139 denotes therapeutic procedures that do not have a specific code. It is used to report individualized therapeutic interventions that fall outside of other, more specific CPT procedure codes.
Service type: Therapeutic procedure, individualized
Typical site of service: Outpatient rehabilitation settings such as physical therapy and occupational therapy clinics, and other ambulatory care settings where one-on-one therapeutic procedures are delivered.
National Reimbursement Benchmarks
Commercial reimbursement for CPT 97139 centers near BUCA’s average commercial rate of $34, with meaningful divergence across major payers. Blue Cross Blue Shield shows both a high mean ($33.2) and the widest interquartile spread (P75–P25 = $15.8), while Cigna and UnitedHealth Group also exhibit large dispersion ($70.9 and $45.9 respectively), reflecting significant variability in negotiated rates across regions and contracting arrangements. Aetna is at the low end with a tight spread (P75–P25 = $2.9), indicating more consistent payments.
Overall, payers span a broad continuum: Aetna’s narrow dispersion contrasts with the pronounced variability for Cigna, UnitedHealth Group, and Blue Cross Blue Shield, which may translate into uneven revenue predictability for providers depending on payer mix. BUCA’s mean of $34 situates within this spectrum as a mid-market benchmark for commercial reimbursement.