Cost analysis for CPT 97164 — Re-evaluation for physical therapy, typically 20 minutes
Average Medicare Payment
$53.22
2023 data
Total Payments (2023)
$23.1M
Services (2023)
430.5K
Price Change (2017–2023)
+25.4%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2017 | $42.43 | $18.9M | 446.5K | — |
| 2018 | $44.41 | $20.1M | 451.9K | +4.7% |
| 2019 | $45.07 | $22.3M | 492.6K | +1.5% |
| 2020 | $46.29 | $16.2M | 348.7K | +2.7% |
| 2021 | $54.22 | $21.9M | 403.0K | +17.1% |
| 2022 | $53.85 | $23.7M | 439.6K | -0.7% |
| 2023 | $53.22 | $23.1M | 430.5K | -1.2% |
The most expensive state pays 1.8x more than the cheapest for this procedure. AK averages $66.78 vs MI at $36.27.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $66.78 | $24.2K | 362 | 17 |
| DC | $58.63 | $57.1K | 974 | 24 |
| NJ | $58.48 | $2.1M | 35.5K | 662 |
| CT | $57.15 | $179.2K | 3.1K | 63 |
| MD | $56.85 | $2.1M | 36.7K | 557 |
| NY | $56.83 | $1.6M | 28.4K | 675 |
| MA | $56.30 | $830.1K | 14.7K | 333 |
| CA | $56.22 | $3.0M | 53.6K | 1.2K |
| VI | $55.41 | $7.4K | 133 | 2 |
| HI | $55.29 | $197.0K | 3.6K | 84 |
| DE | $54.34 | $212.9K | 3.9K | 83 |
| PA | $53.99 | $1.5M | 27.9K | 578 |
| IL | $53.85 | $493.1K | 9.2K | 202 |
| VA | $53.45 | $566.3K | 10.6K | 187 |
| CO | $53.28 | $650.2K | 12.2K | 259 |
| PR | $53.18 | $31.1K | 584 | 22 |
| RI | $53.11 | $82.3K | 1.5K | 43 |
| FL | $53.11 | $992.5K | 18.7K | 343 |
| MT | $53.07 | $69.7K | 1.3K | 36 |
| NH | $52.93 | $75.4K | 1.4K | 31 |
| MN | $52.40 | $63.7K | 1.2K | 39 |
| ND | $52.30 | $10.8K | 206 | 9 |
| WA | $52.24 | $369.8K | 7.1K | 210 |
| ME | $52.17 | $108.2K | 2.1K | 56 |
| TX | $51.88 | $1.7M | 32.0K | 510 |
| AZ | $51.45 | $1.2M | 22.4K | 490 |
| IN | $51.33 | $190.2K | 3.7K | 101 |
| WI | $50.99 | $100.0K | 2.0K | 60 |
| OH | $50.83 | $502.4K | 9.9K | 236 |
| WY | $50.79 | $80.5K | 1.6K | 40 |
| OR | $50.68 | $148.5K | 2.9K | 101 |
| KS | $50.64 | $141.8K | 2.8K | 60 |
| SC | $50.51 | $276.0K | 5.5K | 95 |
| SD | $50.47 | $8.5K | 169 | 9 |
| NE | $50.39 | $128.6K | 2.6K | 63 |
| UT | $50.38 | $132.2K | 2.6K | 76 |
| MO | $50.32 | $286.2K | 5.7K | 102 |
| IA | $50.31 | $314.2K | 6.2K | 150 |
| GA | $50.03 | $209.7K | 4.2K | 88 |
| VT | $50.01 | $96.6K | 1.9K | 41 |
| LA | $49.87 | $274.7K | 5.5K | 98 |
| NM | $49.62 | $75.9K | 1.5K | 33 |
| TN | $49.57 | $305.3K | 6.2K | 140 |
| WV | $49.53 | $114.8K | 2.3K | 56 |
| OK | $49.28 | $72.0K | 1.5K | 42 |
| AR | $49.27 | $89.7K | 1.8K | 38 |
| AL | $49.11 | $122.7K | 2.5K | 61 |
| KY | $48.94 | $281.7K | 5.8K | 126 |
| NC | $48.39 | $473.1K | 9.8K | 203 |
| MS | $47.98 | $82.7K | 1.7K | 37 |
| ID | $47.69 | $84.8K | 1.8K | 49 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Gayle Reed | Physical Therapist in Private Practice | FL | $55.1K | 1.0K | $54.63 |
| Adi Halili | Physical Therapist in Private Practice | AZ | $52.6K | 974 | $54.04 |
| Frank Cawley | Physical Therapist in Private Practice | PA | $51.1K | 973 | $52.55 |
| David Bullock | Physical Therapist in Private Practice | MD | $49.9K | 810 | $61.58 |
| Carol Frazier | Physical Therapist in Private Practice | MD | $44.7K | 792 | $56.48 |
| William Hogan | Physical Therapist in Private Practice | VT | $27.4K | 547 | $50.15 |
| Ariz Mehta | Physical Medicine and Rehabilitation | NJ | $27.2K | 430 | $63.17 |
| Brennon Monroe | Physical Therapist in Private Practice | MD | $27.1K | 435 | $62.26 |
| Ryan Lynch | Physical Therapist in Private Practice | MD | $26.3K | 477 | $55.13 |
| Michele Dyogi | Physical Therapist in Private Practice | TX | $26.0K | 496 | $52.47 |
| Michael Smith | Physical Therapist in Private Practice | TN | $25.9K | 510 | $50.83 |
| Alina Dawson | Physical Therapist in Private Practice | VA | $24.8K | 462 | $53.58 |
| Filemon Bautista | Physical Therapist in Private Practice | TX | $24.6K | 455 | $54.02 |
| Larry Brimhall | Physical Therapist in Private Practice | AZ | $24.2K | 453 | $53.47 |
| Henry Bussey | Physical Therapist in Private Practice | TX | $24.0K | 459 | $52.26 |
| Arnan Sisson | Physical Therapist in Private Practice | VA | $23.9K | 445 | $53.80 |
| Javier Leal | Physical Therapist in Private Practice | TX | $23.3K | 454 | $51.27 |
| Michael Hart | Physical Therapist in Private Practice | FL | $23.1K | 495 | $46.76 |
| Lisa Rozo | Physical Therapist in Private Practice | CO | $23.0K | 419 | $54.89 |
| Andrea Pallais | Physical Therapist in Private Practice | TX | $22.0K | 400 | $55.03 |
Based on the data, CPT 97164 shows a 1.8x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 25.4% since 2017. 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.