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

Occupational therapy evaluation, low complexity

CPT 97165the billing code this page is about

First visit with an occupational therapist to review history, assess daily living skills and set a plan, for a straightforward problem; billed once per evaluation.

Hospitals typically charge $205 cash for this outpatient procedure — the median across 3,366 hospitals that filed a usable cash price; the average of the middle 60% is $210. Most fall between $122 and $335 (20th–80th percentile).

Hospitals
3,366
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 3,366 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
$92$137$205$298$454

The most expensive tenth of hospitals charges at least 4.9× what the cheapest tenth charges ($92 vs $454).

How the prices are spread

$75 – $92: 164 hospitals$75$92 – $114: 231 hospitals$114 – $141: 324 hospitals$114$141 – $174: 420 hospitals$174 – $215: 496 hospitals$174$215 – $266: 513 hospitals$266 – $329: 353 hospitals$266$329 – $406: 255 hospitals$406 – $502: 159 hospitals$406$502 – $620: 115 hospitals$502median $205price bands are equal on a log scale
Hospitals per price band (3,030 of 3,366 — the bands cover the 5th to 95th percentile)
FromToHospitals
$75$92164
$92$114231
$114$141324
$141$174420
$174$215496
$215$266513
$266$329353
$329$406255
$406$502159
$502$620115

By state

The median cash price in each state, against the national median of $205.

Alaska: median $347 across 18 hospitalsAK$347Maine: median $210 across 27 hospitalsME$210Vermont: median $267 across 14 hospitalsVT$267New Hampshire: median $206 across 24 hospitalsNH$206Washington: median $211 across 68 hospitalsWA$211Idaho: median $243 across 23 hospitalsID$243Montana: median $176 across 30 hospitalsMT$176North Dakota: median $295 across 28 hospitalsND$295Minnesota: median $200 across 109 hospitalsMN$200Illinois: median $254 across 141 hospitalsIL$254Wisconsin: median $196 across 102 hospitalsWI$196Michigan: median $198 across 98 hospitalsMI$198New York: median $184 across 110 hospitalsNY$184Massachusetts: median $355 across 53 hospitalsMA$355Oregon: median $248 across 55 hospitalsOR$248Nevada: median $251 across 21 hospitalsNV$251Wyoming: median $175 across 16 hospitalsWY$175South Dakota: median $268 across 44 hospitalsSD$268Iowa: median $179 across 95 hospitalsIA$179Indiana: median $158 across 96 hospitalsIN$158Ohio: median $246 across 143 hospitalsOH$246Pennsylvania: median $227 across 127 hospitalsPA$227New Jersey: median $129 across 45 hospitalsNJ$129Connecticut: median $399 across 23 hospitalsCT$399Rhode Island: median $256 across 10 hospitalsRI$256California: median $271 across 188 hospitalsCA$271Utah: median $224 across 41 hospitalsUT$224Colorado: median $218 across 72 hospitalsCO$218Nebraska: median $173 across 84 hospitalsNE$173Missouri: median $154 across 82 hospitalsMO$154Kentucky: median $218 across 69 hospitalsKY$218West Virginia: median $185 across 39 hospitalsWV$185Virginia: median $216 across 73 hospitalsVA$216Maryland: median $139 across 42 hospitalsMD$139Delaware: 7 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $126 across 50 hospitalsAZ$126New Mexico: median $193 across 29 hospitalsNM$193Kansas: median $153 across 86 hospitalsKS$153Arkansas: median $105 across 32 hospitalsAR$105Tennessee: median $123 across 79 hospitalsTN$123North Carolina: median $180 across 93 hospitalsNC$180South Carolina: median $208 across 53 hospitalsSC$208Oklahoma: median $106 across 62 hospitalsOK$106Louisiana: median $114 across 52 hospitalsLA$114Mississippi: median $121 across 58 hospitalsMS$121Alabama: median $147 across 40 hospitalsAL$147Georgia: median $161 across 109 hospitalsGA$161Hawaii: median $242 across 19 hospitalsHI$242Texas: median $268 across 222 hospitalsTX$268Florida: median $362 across 165 hospitalsFL$362
Cash price by state, most expensive first. National median $205. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Connecticut CT23$399+95%$256 – $412
Florida FL165$362+77%$185 – $748
Massachusetts MA53$355+73%$243 – $416
Alaska AK18$347+69%$200 – $495
North Dakota ND28$295+44%$235 – $390
California CA188$271+33%$182 – $508
Texas TX222$268+31%$133 – $446
South Dakota SD44$268+31%$240 – $351
Vermont VT14$267+30%$193 – $393
Rhode Island RI10$256+25%$84 – $526
Illinois IL141$254+24%$130 – $366
Nevada NV21$251+22%$124 – $354
Oregon OR55$248+21%$153 – $315
Ohio OH143$246+20%$169 – $338
Idaho ID23$243+19%$172 – $253
Hawaii HI19$242+18%$202 – $335
Pennsylvania PA127$227+11%$137 – $411
Utah UT41$224+9%$159 – $293
Colorado CO72$218+7%$136 – $305
Kentucky KY69$218+6%$156 – $311
Virginia VA73$216+5%$121 – $365
Washington WA68$211+3%$144 – $284
Maine ME27$210+3%$117 – $296
South Carolina SC53$208+2%$120 – $314
New Hampshire NH24$206+1%$101 – $343
Minnesota MN109$200−2%$147 – $253
Michigan MI98$198−3%$120 – $226
Wisconsin WI102$196−4%$140 – $254
New Mexico NM29$193−6%$128 – $296
West Virginia WV39$185−10%$114 – $251
New York NY110$184−10%$113 – $369
North Carolina NC93$180−12%$137 – $237
Iowa IA95$179−12%$129 – $236
Montana MT30$176−14%$158 – $248
Wyoming WY16$175−14%$132 – $242
Nebraska NE84$173−16%$139 – $226
Georgia GA109$161−21%$124 – $483
Indiana IN96$158−23%$102 – $233
Missouri MO82$154−25%$98 – $219
Kansas KS86$153−25%$95 – $211
Alabama AL40$147−28%$92 – $278
Maryland MD42$139−32%$94 – $180
New Jersey NJ45$129−37%$119 – $330
Arizona AZ50$126−39%$60 – $607
Tennessee TN79$123−40%$72 – $221
Mississippi MS58$121−41%$87 – $202
Louisiana LA52$114−44%$83 – $204
Oklahoma OK62$106−48%$90 – $171
Arkansas AR32$105−49%$61 – $145
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 $205.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care2,339$205$117 – $361
Children’s73$281$165 – $480
Critical access944$200$136 – $280
Ownership
For-profit462$268$130 – $683
Government619$183$119 – $278
Non-profit2,275$206$122 – $319
System affiliation
Part of a system2,735$212$123 – $347
Independent631$183$117 – $294

Cash price vs list price

Median list price (chargemaster)$344
Median cash price$205
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

2,301 hospitals filed a usable inpatient cash price for this code. The median is $212 and the average of the middle 60% is $215; most fall between $128 and $326.

Cash price percentiles, inpatient, across 2,301 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
$92$144$212$295$437

The most expensive tenth of hospitals charges at least 4.7× what the cheapest tenth charges ($92 vs $437).

Of the 2,441 hospitals that filed this code inpatient, 2,301 gave a usable cash price; 31 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 109 a list price only.

How complete is this

3,366 of the 3,956 hospitals with a price file in our corpus (85%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 3,555 hospitals that filed this code at all gave us
Usable cash price — counted3,366
Cash price carrying a plausibility flag — shown on the compare tool, excluded here46
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 — excluded142
Hospitals that filed this code3,555

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 Occupational Therapy Eval Low Complex 30 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, “Occupational therapy evaluation, low complexity (CPT 97165) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-97165-occupational-therapy-evaluation-low-complexity