CPT 97028
Global XXX ActiveUltraviolet therapy
CPT 97028 Billing & Documentation Guide
CPT code 97028 (Ultraviolet therapy) is classified under Physical Medicine with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.08, a non-facility practice expense RVU of 0.16, and a malpractice RVU of 0.01, a total non-facility RVU of 0.25 and facility RVU of 0.25. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $8.59, though rates vary from $7.43 to $10.85 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 97028, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 97028 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 97028 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 97028
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.08 | 0.08 |
| Practice Expense RVU | 0.16 | 0.16 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 0.25 | 0.25 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 97028
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $9.27 | $9.27 | $8.75 - $10.85 | 29 |
| Florida | $8.68 | $8.68 | $8.28 - $9.08 | 3 |
| Georgia | $8.18 | $8.18 | $7.84 - $8.51 | 2 |
| Illinois | $8.48 | $8.48 | $8.07 - $8.83 | 4 |
| Michigan | $8.16 | $8.16 | $7.93 - $8.39 | 2 |
| North Carolina | $7.87 | $7.87 | $7.87 - $7.87 | 1 |
| New York | $9.21 | $9.21 | $7.98 - $9.82 | 5 |
| Ohio | $7.89 | $7.89 | $7.89 - $7.89 | 1 |
| Pennsylvania | $8.29 | $8.29 | $7.89 - $8.68 | 2 |
| Texas | $8.26 | $8.26 | $7.85 - $8.63 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 97028
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 97028 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0229T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0231T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 62310 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 62311 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 97028
What does CPT code 97028 mean? +
CPT code 97028 represents: Ultraviolet therapy. It's in the Physical Medicine category with a global period of XXX.
What is the Medicare reimbursement for CPT 97028? +
The 2026 Medicare national average non-facility payment for CPT 97028 is $8.59. Rates range from $7.43 to $10.85 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 97028? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 97028? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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