97750

Test or measurement for functional capacity, each 15 minutes

Medicare pricing data for 7,167 providers across 52 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

Test or measurement for functional capacity, each 15 minutes (HCPCS code 97750) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.76, but hospitals typically charge $89.53 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.75

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.76, your out-of-pocket cost would be approximately $5.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.76
Average Hospital Charge
$89.53
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$89.53
Medicare Allowed$28.76
Medicare Payment$22.20

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $22.20 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$33$9016434+16.2%
District of Columbia$31$7428820+9.5%
California$31$9457735,646+9.0%
New Jersey$31$18856623,567+7.4%
Massachusetts$31$591005,663+6.9%
Montana$31$6631379+6.5%
Washington$30$751442,341+5.6%
Maryland$30$7240616,862+5.4%
Rhode Island$30$541380+5.0%
Vermont$30$5610276+4.7%
New York$30$9637117,215+3.1%
New Hampshire$29$6330859+1.9%
South Dakota$29$6927420+1.4%
Connecticut$29$731131,755+1.4%
Virginia$29$6930818,931+0.7%
Michigan$29$9720412,832+0.7%
Wyoming$29$7643994+0.4%
West Virginia$29$6122422-0.3%
Minnesota$28$912045,455-1.3%
Puerto Rico$28$31425-1.6%
Texas$28$7831310,872-1.9%
North Dakota$28$7024261-2.0%
Arizona$28$7323317,637-2.4%
Louisiana$28$66653,820-2.5%
North Carolina$28$9130414,087-2.6%
Florida$28$9545130,859-3.2%
Pennsylvania$28$6042212,836-3.2%
Georgia$28$732196,112-3.2%
Delaware$28$62902,757-3.7%
Wisconsin$28$95981,549-4.1%
Utah$28$69451,637-4.3%
Arkansas$27$59711,428-4.6%
Oregon$27$57411,422-4.7%
Kentucky$27$70642,001-4.8%
Iowa$27$7137253-4.9%
Alabama$27$77905,816-4.9%
Hawaii$27$5717840-5.7%
Illinois$27$1002297,298-5.7%
New Mexico$27$8120595-6.0%
Colorado$27$1031302,771-6.1%
Nebraska$27$8846883-7.4%
Indiana$27$68802,722-7.6%
Kansas$27$60571,036-7.8%
Idaho$26$7934679-8.1%
Ohio$26$672148,091-8.2%
Nevada$26$74522,003-8.6%
Tennessee$26$641152,011-8.6%
Mississippi$26$94321,210-9.5%
South Carolina$26$712107,698-10.1%
Maine$26$5624721-10.3%
Missouri$26$40472,609-11.0%
Oklahoma$25$83633,726-14.3%

⚠️ 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