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Procedure price report · Diagnostic physical, occupational, and speech therapy

Physical therapy evaluation, high complexity

CPT 97163the billing code this page is about

First visit with a physical therapist for a complex or changing condition, with extensive history, examination and clinical decision making; billed once per evaluation.

Hospitals typically charge $254 cash for this outpatient procedure — the median across 3,404 hospitals that filed a usable cash price; the average of the middle 60% is $260. Most fall between $146 and $413 (20th–80th percentile).

Hospitals
3,404
States
50
Filings dated
Nov 2023 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 25, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 3,404 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$110$165$254$372$587

The most expensive tenth of hospitals charges at least 5.3× what the cheapest tenth charges ($110 vs $587).

How the prices are spread

$91 – $113: 217 hospitals$91$113 – $141: 238 hospitals$141 – $175: 308 hospitals$141$175 – $217: 453 hospitals$217 – $270: 447 hospitals$217$270 – $335: 535 hospitals$335 – $416: 373 hospitals$335$416 – $517: 242 hospitals$517 – $643: 154 hospitals$517$643 – $799: 97 hospitals$643median $254price bands are equal on a log scale
Hospitals per price band (3,064 of 3,404 — the bands cover the 5th to 95th percentile)
FromToHospitals
$91$113217
$113$141238
$141$175308
$175$217453
$217$270447
$270$335535
$335$416373
$416$517242
$517$643154
$643$79997

By state

The median cash price in each state, against the national median of $254.

Alaska: median $366 across 19 hospitalsAK$366Maine: median $234 across 28 hospitalsME$234Vermont: median $333 across 14 hospitalsVT$333New Hampshire: median $246 across 24 hospitalsNH$246Washington: median $262 across 71 hospitalsWA$262Idaho: median $234 across 23 hospitalsID$234Montana: median $238 across 34 hospitalsMT$238North Dakota: median $338 across 29 hospitalsND$338Minnesota: median $228 across 103 hospitalsMN$228Illinois: median $309 across 140 hospitalsIL$309Wisconsin: median $283 across 102 hospitalsWI$283Michigan: median $220 across 96 hospitalsMI$220New York: median $264 across 103 hospitalsNY$264Massachusetts: median $365 across 52 hospitalsMA$365Oregon: median $247 across 55 hospitalsOR$247Nevada: median $269 across 22 hospitalsNV$269Wyoming: median $191 across 16 hospitalsWY$191South Dakota: median $317 across 41 hospitalsSD$317Iowa: median $209 across 91 hospitalsIA$209Indiana: median $233 across 97 hospitalsIN$233Ohio: median $293 across 142 hospitalsOH$293Pennsylvania: median $305 across 127 hospitalsPA$305New Jersey: median $126 across 45 hospitalsNJ$126Connecticut: median $413 across 23 hospitalsCT$413Rhode Island: median $256 across 10 hospitalsRI$256California: median $424 across 195 hospitalsCA$424Utah: median $322 across 42 hospitalsUT$322Colorado: median $271 across 74 hospitalsCO$271Nebraska: median $242 across 82 hospitalsNE$242Missouri: median $186 across 81 hospitalsMO$186Kentucky: median $227 across 66 hospitalsKY$227West Virginia: median $222 across 40 hospitalsWV$222Virginia: median $290 across 73 hospitalsVA$290Maryland: median $192 across 42 hospitalsMD$192Delaware: 7 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $185 across 54 hospitalsAZ$185New Mexico: median $332 across 30 hospitalsNM$332Kansas: median $183 across 90 hospitalsKS$183Arkansas: median $132 across 36 hospitalsAR$132Tennessee: median $142 across 80 hospitalsTN$142North Carolina: median $236 across 96 hospitalsNC$236South Carolina: median $278 across 52 hospitalsSC$278Oklahoma: median $136 across 70 hospitalsOK$136Louisiana: median $149 across 54 hospitalsLA$149Mississippi: median $151 across 57 hospitalsMS$151Alabama: median $145 across 42 hospitalsAL$145Georgia: median $208 across 109 hospitalsGA$208Hawaii: median $293 across 20 hospitalsHI$293Texas: median $306 across 235 hospitalsTX$306Florida: median $491 across 170 hospitalsFL$491
Cash price by state, most expensive first. National median $254. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL170$491+94%$201 – $996
California CA195$424+67%$211 – $629
Connecticut CT23$413+63%$256 – $420
Alaska AK19$366+44%$304 – $599
Massachusetts MA52$365+44%$260 – $476
North Dakota ND29$338+33%$270 – $447
Vermont VT14$333+31%$248 – $393
New Mexico NM30$332+31%$184 – $413
Utah UT42$322+27%$167 – $402
South Dakota SD41$317+25%$262 – $383
Illinois IL140$309+22%$140 – $470
Texas TX235$306+21%$138 – $554
Pennsylvania PA127$305+20%$159 – $567
Hawaii HI20$293+15%$289 – $379
Ohio OH142$293+15%$196 – $393
Virginia VA73$290+14%$166 – $444
Wisconsin WI102$283+12%$200 – $343
South Carolina SC52$278+10%$212 – $294
Colorado CO74$271+7%$185 – $399
Nevada NV22$269+6%$194 – $394
New York NY103$264+4%$111 – $445
Washington WA71$262+3%$189 – $371
Rhode Island RI10$256+1%$140 – $575
Oregon OR55$247−3%$197 – $318
New Hampshire NH24$246−3%$142 – $462
Nebraska NE82$242−5%$156 – $300
Montana MT34$238−6%$155 – $292
North Carolina NC96$236−7%$157 – $322
Maine ME28$234−8%$132 – $349
Idaho ID23$234−8%$187 – $287
Indiana IN97$233−8%$125 – $288
Minnesota MN103$228−10%$174 – $303
Kentucky KY66$227−11%$175 – $349
West Virginia WV40$222−12%$141 – $340
Michigan MI96$220−13%$161 – $359
Iowa IA91$209−18%$150 – $281
Georgia GA109$208−18%$137 – $551
Maryland MD42$192−24%$150 – $273
Wyoming WY16$191−25%$165 – $349
Missouri MO81$186−27%$122 – $256
Arizona AZ54$185−27%$104 – $1,151
Kansas KS90$183−28%$120 – $260
Mississippi MS57$151−40%$90 – $202
Louisiana LA54$149−41%$85 – $271
Alabama AL42$145−43%$103 – $370
Tennessee TN80$142−44%$82 – $237
Oklahoma OK70$136−46%$101 – $232
Arkansas AR36$132−48%$123 – $155
New Jersey NJ45$126−50%$120 – $494
Delaware DE7not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $254.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care2,365$255$135 – $456
Children’s72$417$256 – $687
Critical access957$246$166 – $341
Ownership
For-profit482$317$152 – $837
Government637$236$145 – $338
Non-profit2,275$251$146 – $396
System affiliation
Part of a system2,754$258$147 – $426
Independent650$236$145 – $361

Cash price vs list price

Median list price (chargemaster)$426
Median cash price$254
Cash as a share of list, median hospital65%

At the typical hospital, asking for the cash price cuts the list price by about 35%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

2,323 hospitals filed a usable inpatient cash price for this code. The median is $262 and the average of the middle 60% is $266; most fall between $150 and $402.

Cash price percentiles, inpatient, across 2,323 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$111$175$262$372$534

The most expensive tenth of hospitals charges at least 4.8× what the cheapest tenth charges ($111 vs $534).

Of the 2,462 hospitals that filed this code inpatient, 2,323 gave a usable cash price; 24 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 115 a list price only.

How complete is this

3,404 of the 3,956 hospitals with a price file in our corpus (86%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 3,599 hospitals that filed this code at all gave us
Usable cash price — counted3,404
Cash price carrying a plausibility flag — shown on the compare tool, excluded here45
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded1
A list price only, no cash figure — excluded149
Hospitals that filed this code3,599

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 25, 2026; the figures were computed September 25, 2026 from filings loaded through September 25, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Diagnostic physical, occupational, and speech therapy family.

Hospitals file this code under descriptions such as Physical Therapy Evaluation High Complex 45 Mins.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Physical therapy evaluation, high complexity (CPT 97163) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-97163-physical-therapy-evaluation-high-complexity