97803

Therapy procedure reassessment for nutrition management, each 15 minutes

Medicare pricing data for 4,063 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

Therapy procedure reassessment for nutrition management, each 15 minutes (HCPCS code 97803) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $27.09, but hospitals typically charge $68.15 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.42

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $27.09, your out-of-pocket cost would be approximately $5.42. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$27.09
Average Hospital Charge
$68.15
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$68.15
Medicare Allowed$27.09
Medicare Payment$27.09

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $27.09 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$31$10621368+14.7%
California$29$7130717,034+8.6%
New York$29$8531520,145+8.5%
New Jersey$29$671907,695+7.2%
District of Columbia$29$6514786+5.3%
Maryland$28$641046,384+4.6%
Connecticut$28$69511,614+4.2%
Massachusetts$28$841618,381+3.9%
Rhode Island$27$56481,597+1.3%
Illinois$27$5919117,080+0.9%
Washington$27$771253,941+0.0%
Montana$27$3810468-1.1%
Colorado$27$60451,126-1.1%
Wyoming$27$6811424-1.4%
Puerto Rico$27$3536264-1.9%
Virginia$27$53793,020-2.0%
Nevada$27$60473,005-2.1%
South Dakota$27$673160-2.1%
Florida$26$551437,338-2.3%
New Hampshire$26$8030750-2.4%
Minnesota$26$1071503,186-2.5%
Pennsylvania$26$572369,041-3.8%
Oregon$26$85691,305-3.9%
Arizona$26$551255,957-3.9%
Delaware$26$58191,199-4.7%
North Carolina$26$742449,829-4.8%
Texas$26$5924311,895-5.0%
Michigan$26$63551,760-5.1%
Indiana$26$55621,181-5.2%
Missouri$26$61421,253-5.2%
Iowa$26$1047212-5.6%
Kansas$26$51321,544-5.6%
Georgia$25$67551,227-5.9%
New Mexico$25$6514986-6.1%
Wisconsin$25$961074,179-6.1%
South Carolina$25$54301,509-6.2%
Ohio$25$611623,109-7.2%
Kentucky$25$58291,085-7.8%
Oklahoma$25$53502,305-8.1%
Tennessee$25$77542,061-8.1%
Vermont$25$5914207-8.1%
Hawaii$25$63373,012-8.2%
Alabama$25$5432838-8.2%
Utah$25$8329394-8.7%
Nebraska$25$6227766-9.0%
Louisiana$25$51331,237-9.5%
Mississippi$24$6310497-9.6%
Maine$24$5119474-10.1%
North Dakota$24$9919868-10.3%
Arkansas$24$5732492-13.0%
Idaho$24$53461,544-13.3%
West Virginia$22$517122-18.6%

⚠️ 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