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

Occupational therapy evaluation, moderate complexity

CPT 97166the billing code this page is about

First visit with an occupational therapist with a more detailed history and assessment of daily living skills and a plan of care; billed once per evaluation.

Hospitals typically charge $232 cash for this outpatient procedure — the median across 3,337 hospitals that filed a usable cash price; the average of the middle 60% is $240. Most fall between $136 and $382 (20th–80th percentile).

Hospitals
3,337
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 3,337 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
$103$153$232$350$539

The most expensive tenth of hospitals charges at least 5.2× what the cheapest tenth charges ($103 vs $539).

How the prices are spread

$86 – $107: 199 hospitals$86$107 – $133: 271 hospitals$133 – $164: 324 hospitals$133$164 – $204: 447 hospitals$204 – $253: 475 hospitals$204$253 – $314: 428 hospitals$314 – $389: 393 hospitals$314$389 – $483: 236 hospitals$483 – $599: 148 hospitals$483$599 – $743: 84 hospitals$599median $232price bands are equal on a log scale
Hospitals per price band (3,005 of 3,337 — the bands cover the 5th to 95th percentile)
FromToHospitals
$86$107199
$107$133271
$133$164324
$164$204447
$204$253475
$253$314428
$314$389393
$389$483236
$483$599148
$599$74384

By state

The median cash price in each state, against the national median of $232.

Alaska: median $349 across 18 hospitalsAK$349Maine: median $234 across 28 hospitalsME$234Vermont: median $288 across 14 hospitalsVT$288New Hampshire: median $206 across 24 hospitalsNH$206Washington: median $234 across 67 hospitalsWA$234Idaho: median $243 across 23 hospitalsID$243Montana: median $201 across 32 hospitalsMT$201North Dakota: median $306 across 27 hospitalsND$306Minnesota: median $218 across 109 hospitalsMN$218Illinois: median $265 across 140 hospitalsIL$265Wisconsin: median $242 across 102 hospitalsWI$242Michigan: median $230 across 97 hospitalsMI$230New York: median $198 across 98 hospitalsNY$198Massachusetts: median $367 across 50 hospitalsMA$367Oregon: median $248 across 55 hospitalsOR$248Nevada: median $266 across 21 hospitalsNV$266Wyoming: median $198 across 16 hospitalsWY$198South Dakota: median $295 across 43 hospitalsSD$295Iowa: median $199 across 95 hospitalsIA$199Indiana: median $182 across 96 hospitalsIN$182Ohio: median $274 across 142 hospitalsOH$274Pennsylvania: median $281 across 125 hospitalsPA$281New Jersey: median $129 across 45 hospitalsNJ$129Connecticut: median $399 across 23 hospitalsCT$399Rhode Island: median $256 across 10 hospitalsRI$256California: median $343 across 184 hospitalsCA$343Utah: median $351 across 40 hospitalsUT$351Colorado: median $263 across 72 hospitalsCO$263Nebraska: median $207 across 83 hospitalsNE$207Missouri: median $176 across 82 hospitalsMO$176Kentucky: median $229 across 69 hospitalsKY$229West Virginia: median $198 across 38 hospitalsWV$198Virginia: median $261 across 73 hospitalsVA$261Maryland: median $142 across 42 hospitalsMD$142Delaware: 7 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $137 across 50 hospitalsAZ$137New Mexico: median $246 across 29 hospitalsNM$246Kansas: median $167 across 84 hospitalsKS$167Arkansas: median $125 across 32 hospitalsAR$125Tennessee: median $130 across 80 hospitalsTN$130North Carolina: median $215 across 94 hospitalsNC$215South Carolina: median $279 across 53 hospitalsSC$279Oklahoma: median $133 across 63 hospitalsOK$133Louisiana: median $154 across 51 hospitalsLA$154Mississippi: median $124 across 58 hospitalsMS$124Alabama: median $147 across 40 hospitalsAL$147Georgia: median $191 across 106 hospitalsGA$191Hawaii: median $294 across 19 hospitalsHI$294Texas: median $322 across 222 hospitalsTX$322Florida: median $418 across 166 hospitalsFL$418
Cash price by state, most expensive first. National median $232. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL166$418+80%$212 – $924
Connecticut CT23$399+72%$256 – $403
Massachusetts MA50$367+58%$248 – $462
Utah UT40$351+52%$159 – $439
Alaska AK18$349+51%$300 – $617
California CA184$343+48%$211 – $575
Texas TX222$322+39%$165 – $464
North Dakota ND27$306+32%$209 – $390
South Dakota SD43$295+27%$261 – $380
Hawaii HI19$294+27%$248 – $382
Vermont VT14$288+24%$247 – $432
Pennsylvania PA125$281+21%$157 – $530
South Carolina SC53$279+20%$155 – $464
Ohio OH142$274+18%$176 – $405
Nevada NV21$266+15%$145 – $380
Illinois IL140$265+14%$134 – $404
Colorado CO72$263+13%$155 – $339
Virginia VA73$261+13%$126 – $365
Rhode Island RI10$256+11%$92 – $560
Oregon OR55$248+7%$195 – $332
New Mexico NM29$246+6%$160 – $361
Idaho ID23$243+5%$188 – $275
Wisconsin WI102$242+4%$183 – $295
Maine ME28$234+1%$132 – $344
Washington WA67$234+1%$160 – $331
Michigan MI97$230−1%$137 – $297
Kentucky KY69$229−1%$158 – $335
Minnesota MN109$218−6%$161 – $281
North Carolina NC94$215−7%$155 – $290
Nebraska NE83$207−11%$150 – $262
New Hampshire NH24$206−11%$100 – $419
Montana MT32$201−13%$164 – $279
Iowa IA95$199−14%$142 – $258
West Virginia WV38$198−14%$128 – $315
New York NY98$198−15%$113 – $422
Wyoming WY16$198−15%$148 – $339
Georgia GA106$191−17%$125 – $522
Indiana IN96$182−22%$119 – $263
Missouri MO82$176−24%$105 – $228
Kansas KS84$167−28%$114 – $240
Louisiana LA51$154−33%$92 – $222
Alabama AL40$147−37%$97 – $417
Maryland MD42$142−39%$99 – $181
Arizona AZ50$137−41%$78 – $908
Oklahoma OK63$133−43%$101 – $208
Tennessee TN80$130−44%$75 – $223
New Jersey NJ45$129−44%$119 – $414
Arkansas AR32$125−46%$92 – $172
Mississippi MS58$124−47%$91 – $202
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 $232.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care2,313$235$127 – $415
Children’s73$367$220 – $550
Critical access941$224$152 – $320
Ownership
For-profit462$308$142 – $789
Government619$212$135 – $315
Non-profit2,246$230$135 – $366
System affiliation
Part of a system2,711$238$136 – $391
Independent626$211$135 – $333

Cash price vs list price

Median list price (chargemaster)$391
Median cash price$232
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

2,289 hospitals filed a usable inpatient cash price for this code. The median is $240 and the average of the middle 60% is $245; most fall between $144 and $373.

Cash price percentiles, inpatient, across 2,289 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
$106$159$240$346$494

The most expensive tenth of hospitals charges at least 4.7× what the cheapest tenth charges ($106 vs $494).

Of the 2,422 hospitals that filed this code inpatient, 2,289 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 109 a list price only.

How complete is this

3,337 of the 3,956 hospitals with a price file in our corpus (84%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 3,523 hospitals that filed this code at all gave us
Usable cash price — counted3,337
Cash price carrying a plausibility flag — shown on the compare tool, excluded here44
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 — excluded141
Hospitals that filed this code3,523

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 Mod 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, “Occupational therapy evaluation, moderate complexity (CPT 97166) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-97166-occupational-therapy-evaluation-moderate-complexity