Cost analysis for CPT 99497 — Advance care planning, first 30 minutes
Average Medicare Payment
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Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 1.7x more than the cheapest for this procedure. AK averages $71.11 vs MT at $41.87.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $71.11 | $85.5K | 1.2K | 21 |
| DC | $68.79 | $419.7K | 6.1K | 85 |
| NY | $68.76 | $12.7M | 185.0K | 2.1K |
| MD | $66.99 | $5.2M | 77.9K | 851 |
| CA | $66.85 | $20.5M | 307.0K | 2.6K |
| MS | $66.77 | $1.8M | 27.0K | 291 |
| FL | $65.59 | $15.9M | 241.9K | 2.4K |
| MA | $65.50 | $2.9M | 43.5K | 691 |
| AL | $65.16 | $1.9M | 29.6K | 423 |
| GA | $64.46 | $4.9M | 75.7K | 862 |
| IL | $64.33 | $5.3M | 82.7K | 968 |
| VA | $63.84 | $3.7M | 58.3K | 736 |
| WA | $63.53 | $2.4M | 37.6K | 572 |
| CT | $63.28 | $1.3M | 20.8K | 351 |
| PR | $63.11 | $24.0K | 381 | 5 |
| AZ | $62.47 | $4.0M | 64.6K | 723 |
| NJ | $62.47 | $5.3M | 84.9K | 1.1K |
| TX | $62.39 | $11.5M | 184.1K | 2.4K |
| WV | $61.34 | $574.6K | 9.4K | 114 |
| NM | $61.01 | $415.0K | 6.8K | 97 |
| NC | $60.68 | $4.2M | 68.7K | 1.1K |
| PA | $60.68 | $3.7M | 61.3K | 924 |
| LA | $60.56 | $1.6M | 25.7K | 329 |
| WI | $60.28 | $649.6K | 10.8K | 186 |
| KY | $60.13 | $1.6M | 27.3K | 334 |
| OK | $60.04 | $1.5M | 24.6K | 305 |
| UT | $60.00 | $1.1M | 19.1K | 200 |
| NV | $59.21 | $3.0M | 51.0K | 398 |
| IN | $58.43 | $2.1M | 36.1K | 473 |
| SC | $58.21 | $3.6M | 61.4K | 710 |
| HI | $58.05 | $531.0K | 9.1K | 125 |
| OR | $57.81 | $658.6K | 11.4K | 195 |
| ID | $57.10 | $471.0K | 8.2K | 107 |
| ME | $56.37 | $130.4K | 2.3K | 52 |
| KS | $56.21 | $508.2K | 9.0K | 156 |
| ND | $56.14 | $47.5K | 847 | 19 |
| MO | $55.83 | $1.1M | 20.0K | 275 |
| TN | $55.79 | $3.0M | 53.5K | 772 |
| RI | $55.71 | $415.3K | 7.5K | 104 |
| OH | $55.60 | $2.8M | 50.8K | 746 |
| MI | $55.57 | $3.3M | 59.6K | 966 |
| WY | $55.06 | $101.1K | 1.8K | 20 |
| XX | $54.85 | $12.5K | 227 | 1 |
| NH | $54.47 | $261.4K | 4.8K | 69 |
| IA | $54.01 | $332.7K | 6.2K | 96 |
| VT | $53.51 | $33.4K | 624 | 15 |
| MN | $52.88 | $418.3K | 7.9K | 176 |
| AR | $52.80 | $1.0M | 19.6K | 240 |
| CO | $52.70 | $1.6M | 29.9K | 414 |
| SD | $52.12 | $75.6K | 1.5K | 24 |
| DE | $50.61 | $467.4K | 9.2K | 105 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Nicholas Jauregui | Family Practice | CA | $388.9K | 5.7K | $67.99 |
| Maria Ortiz | Family Practice | CA | $227.2K | 3.0K | $76.55 |
| Shylee Tiamson | Nurse Practitioner | CA | $224.4K | 4.3K | $52.06 |
| Kenneth Ares | Nurse Practitioner | NV | $211.1K | 3.8K | $55.00 |
| David Kay | Family Practice | CA | $195.6K | 3.1K | $62.36 |
| Kerwin Yap | Nurse Practitioner | NV | $178.2K | 3.3K | $54.00 |
| Ani Shirinyan | Nurse Practitioner | CA | $141.0K | 2.6K | $53.65 |
| Rafael Penunuri | General Practice | CA | $126.8K | 1.8K | $70.39 |
| Tigalat Shalita | Family Practice | CA | $124.8K | 1.9K | $65.90 |
| Renato Alfonso | Internal Medicine | FL | $119.3K | 1.5K | $79.60 |
| Letasha Lewis | Nurse Practitioner | IL | $118.1K | 2.2K | $52.69 |
| Alex Dickert | Family Practice | FL | $115.6K | 1.4K | $80.75 |
| Tollin Sullivan | Family Practice | CA | $114.9K | 1.4K | $83.59 |
| Rakesh Malik | Internal Medicine | MD | $113.5K | 1.3K | $87.08 |
| Angela Mcguire | General Practice | OK | $103.9K | 1.8K | $59.02 |
| Jayson Bautista | Nurse Practitioner | NV | $103.5K | 1.9K | $54.77 |
| Hermilito Villar | General Practice | CA | $101.9K | 1.4K | $75.35 |
| John Meier | Nurse Practitioner | CA | $101.7K | 1.8K | $56.29 |
| Marc Makhani | Internal Medicine | CA | $98.0K | 1.5K | $66.96 |
| Ajith Purush | General Practice | AZ | $96.9K | 1.2K | $79.20 |
Based on the data, CPT 99497 shows a 1.7x variation in pricing across states — moderate variation 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.