West Virginia workers’ comp
Code 97760 — maximum allowable reimbursement
WEST VIRGINIA
Maximum allowable (non-facility)
$57.28
Single statewide rate
Show your work — how this rate is computed
By statute (W. Va. Code §23-4-3(a)(4)), West Virginia sets the workers’-comp maximum at 135% of the Medicare fee for this code in the WEST VIRGINIA Medicare locality.
- RVUs: CMS National Physician Fee Schedule Relative Value File; GPCIs: CMS Geographic Practice Cost Indices (the WEST VIRGINIA Medicare locality).
- The 135%-of-Medicare rule: West Virginiaworkers’ comp statute (W. Va. Code §23-4-3(a)(4)) — source ↗
- The Medicare fee itself is verified to the penny against the CMS Physician Fee Schedule Look-Up Tool; a code Medicare does not price is shown as an honest gap.
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