Initial orthotic management and training, including assessment, fitting, and teaching the patient to use the device, for upper limb, lower limb, or trunk, per 15 minutes.
- Medicare
- $46.09
- Work RVU
- 0.5
- Global, days
- Region
- Hand
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Device type and body part
- Assessment and fitting details
- Training on donning, doffing, wear schedule, and care
- Skin check and patient tolerance
- Minutes of direct contact
- Device L-code billed separately if supplied
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
97760 covers the first encounter for orthotic management and training. It includes assessing the need, fitting the device, and training the patient to put it on, wear it, and care for it. It is timed in 15-minute units. Later visits for adjustments and continued training use 97763.
Hand therapy is the biggest ortho user. A therapist fabricating a custom thermoplastic splint after a flexor tendon repair or a thumb ligament injury bills the training time here. It also applies to fitting an ankle foot orthosis after a peroneal nerve injury or a spinal brace after a compression fracture.
The device is billed separately, usually with an L-code, and the rules for those differ from the training code. Do not bill 97760 for the same extremity on the same day as gait training (97116); CPT bars that pairing. Document the device, the fitting, the training, skin checks, and minutes. Medicare requires GP or GO and applies the 8-minute rule.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.5) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.38) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.5 |
| Practice expense RVU | 0.87 |
| Malpractice RVU | 0.01 |
| Total RVU | 1.38 |
| Medicare national rate | $46.09 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $46.09 |
Common denial reasons
The recurring reasons claims for CPT 97760 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with 97116 for the same extremity
- Subsequent visit billed as 97760 instead of 97763
- Units exceed documented minutes
- Missing GP or GO modifier
- Fitting time already included in the custom device payment billed again as 97760
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What is the difference between 97760 and 97763?
02Can 97760 be billed with gait training?
03Is the splint billed with 97760?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the device, fit, training, and wear schedule in the note, so the initial orthotic visit is documented separately from the device itself.
See how Mira captures CPT 97760 documentation