97110

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes

Medicare pricing data for 104,595 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 64.8 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS code 97110) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $23.39, but hospitals typically charge $67.23 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.68

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $23.39, your out-of-pocket cost would be approximately $4.68. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$23.39
Average Hospital Charge
$67.23
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$67.23
Medicare Allowed$23.39
Medicare Payment$18.05

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $18.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$31$96374153,711+32.8%
New York$25$708,7966,835,433+8.3%
California$25$589,2316,009,655+7.7%
District of Columbia$25$6924290,748+7.3%
New Jersey$25$975,4834,795,121+7.1%
Connecticut$25$671,377636,067+6.0%
Massachusetts$25$632,5371,484,788+5.5%
Hawaii$25$52593289,083+5.1%
Maryland$24$642,6451,762,387+2.4%
Colorado$24$682,618858,715+2.2%
Rhode Island$24$70537292,751+2.1%
North Dakota$24$73374138,571+2.0%
Vermont$24$57285120,988+1.8%
New Hampshire$24$64506220,402+1.6%
Montana$24$57664297,903+1.5%
Washington$24$633,2401,172,026+1.2%
Minnesota$24$862,139556,562+0.7%
South Dakota$23$62378227,258+0.1%
Puerto Rico$23$3318625,040-0.1%
Oregon$23$691,534451,220-0.3%
Nevada$23$68889614,140-0.3%
Wyoming$23$58391339,120-0.6%
Virginia$23$642,7981,792,261-0.8%
Pennsylvania$23$614,1692,815,491-1.2%
Illinois$23$755,0993,050,299-2.1%
Maine$23$64600183,281-2.1%
Wisconsin$23$922,135602,412-2.4%
Delaware$23$71567486,312-2.7%
Florida$23$715,3334,851,422-2.9%
Utah$23$51898501,146-3.5%
Arizona$22$652,5261,668,207-4.0%
Michigan$22$743,4811,375,752-4.3%
North Carolina$22$633,1891,635,481-4.5%
Texas$22$654,9743,009,919-4.5%
Idaho$22$50702406,557-4.8%
Louisiana$22$531,2951,184,243-4.8%
Georgia$22$602,9411,605,435-4.9%
Nebraska$22$63883638,143-5.3%
Kansas$22$56932586,019-5.5%
Iowa$22$671,204562,671-5.5%
Missouri$22$661,372812,747-5.9%
South Carolina$22$601,6331,585,277-6.1%
Tennessee$22$592,4211,371,198-6.3%
Ohio$22$632,3321,257,706-6.5%
Indiana$22$751,923943,939-6.8%
New Mexico$22$58450369,793-6.8%
Arkansas$22$55872824,057-7.7%
Oklahoma$22$60846686,118-7.7%
Kentucky$22$581,223645,054-7.8%
Mississippi$21$56844881,395-9.0%
West Virginia$21$52407292,389-9.1%
Alabama$21$571,414801,772-9.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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