CARC Code 97
Payment for this service is bundled into another service already paid.
What this denial means
When you see CARC code 97 on your Explanation of Benefits (EOB), it means your insurer has denied the claim with the following reason: payment for this service is bundled into another service already paid.
This code is one of the most common denial reasons in the CARC system and appears across both employer-sponsored and ACA marketplace plans. How you respond depends on whether the denial is a patient-side or provider-side issue.
Can you appeal this?
This is typically a provider billing matter. Bundling (CARC 97) is usually a CO provider write-off resolved between your provider and the insurer via NCCI rules — you typically owe nothing. Confirm the Group Code before appealing.
Start by contacting your provider's billing office. In many cases you may owe nothing — the adjustment is between your provider and the insurer. If you believe the denial was applied incorrectly, your provider can submit a corrected claim.
Related reading
Not legal or medical advice. Rebuttal is a document drafting tool, not a law firm. Review your letter before submitting and consult a licensed professional for legal questions specific to your plan.