Cost analysis for CPT 97161 — Evaluation for physical therapy, typically 20 minutes
Average Medicare Payment
N/A
Total Payments (Latest)
N/A
Services (Latest)
N/A
Price Change (–)
N/A
The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $92.75 vs MS at $66.47.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $92.75 | $458.0K | 4.9K | 154 |
| DC | $82.56 | $174.5K | 2.1K | 70 |
| NY | $81.23 | $11.7M | 144.0K | 3.2K |
| NJ | $80.77 | $5.4M | 67.0K | 1.7K |
| CT | $79.04 | $1.3M | 16.9K | 497 |
| CA | $78.80 | $13.0M | 164.6K | 3.3K |
| MD | $78.74 | $3.6M | 45.1K | 967 |
| MA | $78.54 | $3.7M | 47.5K | 1.1K |
| RI | $77.38 | $756.8K | 9.8K | 273 |
| HI | $75.07 | $464.0K | 6.2K | 212 |
| VA | $74.91 | $3.4M | 45.3K | 1.1K |
| NH | $74.66 | $529.3K | 7.1K | 199 |
| CO | $74.57 | $2.0M | 26.9K | 803 |
| IL | $74.55 | $4.8M | 64.7K | 1.5K |
| DE | $74.03 | $816.0K | 11.0K | 227 |
| PA | $73.73 | $3.7M | 50.3K | 1.3K |
| WA | $73.71 | $3.1M | 41.8K | 1.2K |
| FL | $73.65 | $8.4M | 113.9K | 1.8K |
| NV | $73.26 | $1.1M | 14.9K | 315 |
| MN | $72.73 | $2.3M | 31.2K | 942 |
| MI | $72.63 | $2.0M | 27.4K | 890 |
| VI | $72.50 | $25.5K | 352 | 7 |
| SD | $72.23 | $559.6K | 7.7K | 176 |
| ND | $72.18 | $457.9K | 6.3K | 167 |
| TX | $71.89 | $4.4M | 60.9K | 1.5K |
| WY | $71.44 | $474.9K | 6.6K | 182 |
| PR | $71.43 | $94.5K | 1.3K | 36 |
| AZ | $71.19 | $3.8M | 53.6K | 1.1K |
| OR | $71.14 | $916.7K | 12.9K | 410 |
| NC | $71.04 | $3.8M | 53.0K | 1.2K |
| ME | $71.02 | $334.7K | 4.7K | 167 |
| SC | $70.87 | $2.2M | 30.6K | 598 |
| GA | $70.82 | $2.6M | 36.0K | 830 |
| MT | $70.67 | $643.7K | 9.1K | 264 |
| OH | $70.10 | $2.3M | 33.3K | 782 |
| IN | $69.82 | $1.5M | 20.9K | 511 |
| VT | $69.68 | $389.0K | 5.6K | 161 |
| WI | $69.29 | $827.4K | 11.9K | 434 |
| MO | $69.26 | $1.1M | 15.7K | 402 |
| NM | $69.25 | $457.7K | 6.6K | 150 |
| LA | $69.08 | $1.3M | 19.3K | 449 |
| KS | $68.86 | $888.0K | 12.9K | 290 |
| NE | $68.83 | $1.0M | 14.7K | 367 |
| OK | $68.80 | $850.0K | 12.4K | 290 |
| IA | $68.52 | $1.1M | 16.5K | 419 |
| AL | $68.45 | $1.7M | 24.7K | 547 |
| UT | $68.05 | $724.4K | 10.6K | 252 |
| AR | $68.00 | $1.2M | 17.2K | 358 |
| KY | $67.98 | $1.1M | 16.1K | 386 |
| TN | $67.98 | $2.3M | 33.9K | 774 |
| ID | $67.21 | $526.4K | 7.8K | 205 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Ryan Urenda | Physical Therapist in Private Practice | FL | $85.9K | 1.1K | $77.57 |
| Patricia Freire | Physical Therapist in Private Practice | FL | $78.2K | 981 | $79.76 |
| Kien Tran | Internal Medicine | CA | $62.5K | 786 | $79.49 |
| Ken Richards | Physical Therapist in Private Practice | CA | $56.3K | 725 | $77.63 |
| Chand Parveen Shaik | Physical Therapist in Private Practice | NY | $54.9K | 607 | $90.50 |
| John Mckenzie | Physical Therapist in Private Practice | TX | $39.4K | 545 | $72.30 |
| Utkarsh Patel | Physical Therapist in Private Practice | FL | $38.7K | 510 | $75.98 |
| Lissa Trevino | Physical Therapist in Private Practice | CA | $38.0K | 445 | $85.44 |
| Diane Hodges Popps | Physical Therapist in Private Practice | TX | $37.7K | 521 | $72.38 |
| Scott Czujko | Physical Therapist in Private Practice | NY | $35.8K | 417 | $85.95 |
| Thomas White | Physical Therapist in Private Practice | AZ | $35.6K | 480 | $74.15 |
| Thomas Lange | Physical Therapist in Private Practice | FL | $35.3K | 441 | $79.96 |
| Larry Brimhall | Physical Therapist in Private Practice | AZ | $34.3K | 480 | $71.42 |
| Caryn Chomsky | Physical Therapist in Private Practice | FL | $34.1K | 439 | $77.72 |
| Robin Pflieger | Physical Therapist in Private Practice | NJ | $33.5K | 435 | $77.00 |
| Rudi Ide | Physical Therapist in Private Practice | FL | $31.7K | 403 | $78.67 |
| Michelle Henkel | Physical Therapist in Private Practice | IL | $31.6K | 391 | $80.92 |
| Sid Mosiman | Physical Therapist in Private Practice | NM | $31.3K | 436 | $71.84 |
| James Pullman | Physical Therapist in Private Practice | MS | $31.3K | 488 | $64.10 |
| Rodney Velazquez | Physical Therapist in Private Practice | FL | $30.6K | 414 | $74.01 |
Based on the data, CPT 97161 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.
Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.