97140

Therapy procedure using manual technique, each 15 minutes

Medicare pricing data for 94,348 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 29.5 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 manual technique, each 15 minutes (HCPCS code 97140) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $21.06, but hospitals typically charge $65.47 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.21

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $21.06, your out-of-pocket cost would be approximately $4.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$21.06
Average Hospital Charge
$65.47
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$65.47
Medicare Allowed$21.06
Medicare Payment$16.26

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $16.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$28$8935578,777+32.6%
New York$23$717,6202,903,421+7.8%
District of Columbia$23$7122049,364+7.7%
New Jersey$22$934,9482,101,740+6.3%
California$22$598,3493,701,870+5.9%
Connecticut$22$671,266350,405+3.6%
Massachusetts$22$612,364747,536+2.7%
Maryland$22$632,445941,649+2.3%
Hawaii$21$50524135,453+1.8%
North Dakota$21$6832077,275+1.0%
Vermont$21$6127784,345+0.7%
Colorado$21$672,493720,570+0.4%
Rhode Island$21$71508158,035+0.3%
Washington$21$603,052688,875-0.0%
Virginia$21$652,507760,154-0.3%
Montana$21$54636150,676-0.8%
New Hampshire$21$61479156,850-0.9%
Minnesota$21$761,912222,178-1.2%
Illinois$21$744,4811,095,816-1.4%
Pennsylvania$21$593,7461,268,639-1.4%
Oregon$21$641,448311,517-2.1%
South Dakota$21$6335291,379-2.2%
Delaware$21$76534202,169-2.3%
Maine$21$66536120,279-2.3%
Nevada$21$69800289,686-2.5%
Wyoming$21$56390225,435-2.5%
Michigan$20$723,262887,760-3.4%
Florida$20$664,7611,807,299-3.5%
Wisconsin$20$901,956296,557-3.7%
Arizona$20$642,384984,580-3.7%
Georgia$20$572,619614,592-3.7%
Puerto Rico$20$30825,333-4.0%
Texas$20$634,3571,026,526-4.2%
North Carolina$20$602,867709,843-4.6%
Utah$20$52830229,101-4.9%
Missouri$20$651,203291,326-5.1%
New Mexico$20$56418132,845-5.6%
Nebraska$20$60777244,457-5.6%
Louisiana$20$531,159429,428-5.8%
Iowa$20$651,130296,470-5.9%
South Carolina$20$571,471510,702-6.0%
Kansas$20$53848214,741-6.5%
Indiana$20$691,720427,716-6.5%
Tennessee$20$522,175633,013-6.5%
Idaho$20$49677242,381-6.7%
Ohio$20$611,901426,708-6.8%
Kentucky$19$581,096301,484-7.5%
Mississippi$19$59748216,784-7.5%
Arkansas$19$56744171,735-7.5%
Oklahoma$19$60765307,027-8.0%
West Virginia$19$55384114,662-8.4%
Alabama$19$491,342358,693-8.5%

⚠️ 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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