97810

Acupuncture, initial 15 minutes

Medicare pricing data for 995 providers across 38 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

Acupuncture, initial 15 minutes (HCPCS code 97810) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $39.74, but hospitals typically charge $115.86 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.95

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $39.74, your out-of-pocket cost would be approximately $7.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$39.74
Average Hospital Charge
$115.86
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$115.86
Medicare Allowed$39.74
Medicare Payment$30.82

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $30.82 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$43$902498+8.3%
New York$43$1078812,708+7.6%
California$41$9614920,196+4.0%
New Jersey$41$1949013,583+3.8%
Connecticut$41$14312657+2.3%
Massachusetts$39$126161,320-1.0%
Maryland$39$86231,548-1.6%
Pennsylvania$38$120572,683-3.2%
Illinois$38$90201,612-3.6%
Hawaii$38$764310-3.7%
Nevada$38$1024415-4.0%
Michigan$38$105331,643-4.8%
Oregon$38$66132,379-5.1%
Virginia$38$11315413-5.2%
Texas$38$201221,158-5.6%
Washington$37$9318894-6.4%
South Dakota$37$703454-6.5%
Minnesota$37$1231303,461-6.9%
Delaware$36$797308-8.5%
Georgia$36$1358523-8.6%
Florida$36$82463,206-9.1%
South Carolina$36$1385187-9.1%
New Hampshire$36$768380-9.3%
Wisconsin$36$60361,383-9.3%
Arizona$36$110292,073-9.8%
Missouri$36$787214-9.9%
Alabama$36$58271-10.1%
North Carolina$36$8318356-10.3%
Indiana$35$769196-11.4%
Ohio$35$90292,226-12.3%
Colorado$35$69241,007-12.5%
New Mexico$35$858605-12.6%
Nebraska$34$1023343-14.2%
Tennessee$33$58596-16.2%
Maine$33$7112327-18.2%
Idaho$31$75215-22.4%
Vermont$30$31177-25.2%
Kentucky$29$76254-26.4%

⚠️ 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