CPT 97139: Unlisted Therapeutic Procedure
Commercial payers pay $34 on average nationally for this procedure.
CPT code 97139 represents an unlisted therapeutic procedure used to report therapeutic interventions not described by a specific CPT code, typically delivered as one-on-one therapeutic procedures focused on improving function, mobility, pain, or strength in an outpatient rehabilitation or clinic setting; use of 97139 documents a distinct therapeutic service provided when standard procedure codes do not accurately capture the clinical treatment performed.
For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.
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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.