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

Occupational therapy evaluation, high complexity

CPT 97167the billing code this page is about

First visit with an occupational therapist for a complex situation, with extensive history, detailed assessment of daily function and clinical decision making; billed once per evaluation.

Hospitals typically charge $258 cash for this outpatient procedure — the median across 3,266 hospitals that filed a usable cash price; the average of the middle 60% is $267. Most fall between $150 and $436 (20th–80th percentile).

Hospitals
3,266
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 3,266 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$166$258$386$615

The most expensive tenth of hospitals charges at least 5.5× what the cheapest tenth charges ($111 vs $615).

How the prices are spread

$92 – $114: 187 hospitals$92$114 – $142: 248 hospitals$142 – $178: 319 hospitals$142$178 – $222: 403 hospitals$222 – $277: 448 hospitals$222$277 – $345: 465 hospitals$345 – $431: 357 hospitals$345$431 – $537: 244 hospitals$537 – $670: 165 hospitals$537$670 – $837: 104 hospitals$670median $258price bands are equal on a log scale
Hospitals per price band (2,940 of 3,266 — the bands cover the 5th to 95th percentile)
FromToHospitals
$92$114187
$114$142248
$142$178319
$178$222403
$222$277448
$277$345465
$345$431357
$431$537244
$537$670165
$670$837104

By state

The median cash price in each state, against the national median of $258.

Alaska: median $412 across 18 hospitalsAK$412Maine: median $246 across 27 hospitalsME$246Vermont: median $305 across 14 hospitalsVT$305New Hampshire: median $206 across 21 hospitalsNH$206Washington: median $252 across 66 hospitalsWA$252Idaho: median $253 across 22 hospitalsID$253Montana: median $227 across 30 hospitalsMT$227North Dakota: median $312 across 26 hospitalsND$312Minnesota: median $234 across 103 hospitalsMN$234Illinois: median $330 across 135 hospitalsIL$330Wisconsin: median $287 across 100 hospitalsWI$287Michigan: median $242 across 96 hospitalsMI$242New York: median $224 across 97 hospitalsNY$224Massachusetts: median $375 across 49 hospitalsMA$375Oregon: median $252 across 54 hospitalsOR$252Nevada: median $262 across 20 hospitalsNV$262Wyoming: median $222 across 16 hospitalsWY$222South Dakota: median $315 across 32 hospitalsSD$315Iowa: median $216 across 90 hospitalsIA$216Indiana: median $227 across 95 hospitalsIN$227Ohio: median $289 across 141 hospitalsOH$289Pennsylvania: median $319 across 125 hospitalsPA$319New Jersey: median $129 across 45 hospitalsNJ$129Connecticut: median $399 across 22 hospitalsCT$399Rhode Island: median $256 across 10 hospitalsRI$256California: median $432 across 184 hospitalsCA$432Utah: median $435 across 41 hospitalsUT$435Colorado: median $271 across 72 hospitalsCO$271Nebraska: median $232 across 80 hospitalsNE$232Missouri: median $200 across 82 hospitalsMO$200Kentucky: median $270 across 67 hospitalsKY$270West Virginia: median $209 across 36 hospitalsWV$209Virginia: median $281 across 73 hospitalsVA$281Maryland: median $143 across 42 hospitalsMD$143Delaware: 7 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $163 across 50 hospitalsAZ$163New Mexico: median $325 across 29 hospitalsNM$325Kansas: median $185 across 83 hospitalsKS$185Arkansas: median $138 across 31 hospitalsAR$138Tennessee: median $130 across 77 hospitalsTN$130North Carolina: median $239 across 91 hospitalsNC$239South Carolina: median $369 across 52 hospitalsSC$369Oklahoma: median $145 across 64 hospitalsOK$145Louisiana: median $154 across 51 hospitalsLA$154Mississippi: median $130 across 59 hospitalsMS$130Alabama: median $159 across 40 hospitalsAL$159Georgia: median $207 across 106 hospitalsGA$207Hawaii: median $328 across 19 hospitalsHI$328Texas: median $344 across 218 hospitalsTX$344Florida: median $491 across 158 hospitalsFL$491
Cash price by state, most expensive first. National median $258. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL158$491+90%$250 – $1,003
Utah UT41$435+68%$204 – $545
California CA184$432+67%$221 – $700
Alaska AK18$412+60%$330 – $679
Connecticut CT22$399+54%$315 – $420
Massachusetts MA49$375+45%$248 – $491
South Carolina SC52$369+43%$222 – $464
Texas TX218$344+33%$185 – $559
Illinois IL135$330+28%$141 – $520
Hawaii HI19$328+27%$254 – $439
New Mexico NM29$325+26%$160 – $437
Pennsylvania PA125$319+24%$169 – $581
South Dakota SD32$315+22%$262 – $382
North Dakota ND26$312+21%$241 – $418
Vermont VT14$305+18%$247 – $521
Ohio OH141$289+12%$203 – $438
Wisconsin WI100$287+11%$200 – $344
Virginia VA73$281+9%$193 – $385
Colorado CO72$271+5%$178 – $412
Kentucky KY67$270+5%$169 – $368
Nevada NV20$262+1%$172 – $404
Rhode Island RI10$256−1%$124 – $590
Idaho ID22$253−2%$204 – $309
Oregon OR54$252−2%$202 – $346
Washington WA66$252−2%$191 – $385
Maine ME27$246−5%$162 – $358
Michigan MI96$242−6%$160 – $359
North Carolina NC91$239−7%$157 – $359
Minnesota MN103$234−9%$180 – $303
Nebraska NE80$232−10%$154 – $293
Indiana IN95$227−12%$131 – $309
Montana MT30$227−12%$164 – $288
New York NY97$224−13%$113 – $504
Wyoming WY16$222−14%$157 – $437
Iowa IA90$216−16%$150 – $267
West Virginia WV36$209−19%$162 – $338
Georgia GA106$207−20%$133 – $592
New Hampshire NH21$206−20%$172 – $462
Missouri MO82$200−22%$122 – $256
Kansas KS83$185−28%$135 – $324
Arizona AZ50$163−37%$98 – $1,199
Alabama AL40$159−38%$97 – $557
Louisiana LA51$154−40%$95 – $244
Oklahoma OK64$145−44%$108 – $246
Maryland MD42$143−45%$99 – $181
Arkansas AR31$138−47%$113 – $193
Mississippi MS59$130−50%$94 – $202
Tennessee TN77$130−50%$79 – $297
New Jersey NJ45$129−50%$121 – $477
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 $258.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care2,285$262$139 – $476
Children’s72$458$264 – $696
Critical access899$246$162 – $350
Ownership
For-profit456$343$158 – $882
Government598$235$147 – $359
Non-profit2,202$257$150 – $416
System affiliation
Part of a system2,653$263$151 – $455
Independent613$243$147 – $377

Cash price vs list price

Median list price (chargemaster)$439
Median cash price$258
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

2,238 hospitals filed a usable inpatient cash price for this code. The median is $266 and the average of the middle 60% is $273; most fall between $154 and $430.

Cash price percentiles, inpatient, across 2,238 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
$117$177$266$380$564

The most expensive tenth of hospitals charges at least 4.8× what the cheapest tenth charges ($117 vs $564).

Of the 2,375 hospitals that filed this code inpatient, 2,238 gave a usable cash price; 30 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 107 a list price only.

How complete is this

3,266 of the 3,956 hospitals with a price file in our corpus (83%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 3,456 hospitals that filed this code at all gave us
Usable cash price — counted3,266
Cash price carrying a plausibility flag — shown on the compare tool, excluded here50
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded2
A list price only, no cash figure — excluded138
Hospitals that filed this code3,456

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 High Complex 60 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, high complexity (CPT 97167) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-97167-occupational-therapy-evaluation-high-complexity