97533

Therapy procedure using sensory experiences

Medicare pricing data for 740 providers across 31 states

🤖AI Overview

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 sensory experiences (HCPCS code 97533) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.54, but hospitals typically charge $90.46 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.31

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $51.54, your out-of-pocket cost would be approximately $10.31. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$51.54
Average Hospital Charge
$90.46
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$90.46
Medicare Allowed$51.54
Medicare Payment$40.37

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $40.37 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$62$110252,106+20.1%
Nevada$61$9911927+18.6%
California$60$1279813,359+15.6%
North Dakota$57$100228+11.4%
Louisiana$56$1099273+9.4%
Wisconsin$56$89579+9.0%
Maryland$56$109201,221+8.5%
Colorado$55$106271,372+7.5%
Minnesota$55$1001150+7.5%
Alabama$55$98861+7.1%
Missouri$55$1066391+6.7%
Oregon$54$73573+5.1%
Utah$54$81743+4.2%
Kentucky$53$9721176+3.5%
Indiana$53$17161,059+3.2%
Puerto Rico$53$689887+2.9%
North Carolina$53$7011418+1.9%
Washington$52$731369+1.7%
Georgia$51$67883,892-0.7%
New York$51$63864,875-1.1%
Texas$51$11032916-1.4%
Arizona$51$71173,433-1.9%
South Dakota$50$956133-3.7%
Michigan$49$13814121-5.1%
Ohio$48$7413273-7.3%
South Carolina$47$929136-8.3%
Illinois$47$128191,509-9.1%
Tennessee$45$73411,460-12.6%
Pennsylvania$45$66111,137-13.0%
Florida$45$705616,885-13.6%
Virginia$43$5711463-15.8%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber