CPT 97533
Global XXX ActiveSensory integration
CPT 97533 Billing & Documentation Guide
CPT code 97533 (Sensory integration) is classified under Physical Medicine with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.48, a non-facility practice expense RVU of 1.33, and a malpractice RVU of 0.01, a total non-facility RVU of 1.82 and facility RVU of 1.82. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $63.01, though rates vary from $54.36 to $82.03 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 97533, 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 97533 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 4 units of 97533 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 97533
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.48 | 0.48 |
| Practice Expense RVU | 1.33 | 1.33 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 1.82 | 1.82 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 97533
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 | $69.35 | $69.35 | $65.17 - $82.03 | 29 |
| Florida | $61.25 | $61.25 | $59 - $63.12 | 3 |
| Georgia | $58.84 | $58.84 | $56.06 - $61.62 | 2 |
| Illinois | $59.65 | $59.65 | $57.11 - $62.36 | 4 |
| Michigan | $58.22 | $58.22 | $56.97 - $59.46 | 2 |
| North Carolina | $57.69 | $57.69 | $57.69 - $57.69 | 1 |
| New York | $66.81 | $66.81 | $58.47 - $70.5 | 5 |
| Ohio | $56.93 | $56.93 | $56.93 - $56.93 | 1 |
| Pennsylvania | $60.05 | $60.05 | $57.13 - $62.96 | 2 |
| Texas | $60.17 | $60.17 | $56.77 - $63.36 | 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 97533
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 97533 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 |
| 0373T | Column 1 (primary), can be billed with modifier | No | 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 |
Frequently Asked Questions, CPT 97533
What does CPT code 97533 mean? +
CPT code 97533 represents: Sensory integration. It's in the Physical Medicine category with a global period of XXX.
What is the Medicare reimbursement for CPT 97533? +
The 2026 Medicare national average non-facility payment for CPT 97533 is $63.01. Rates range from $54.36 to $82.03 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 97533? +
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 97533? +
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 May 31, 2026.
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