97110

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes

Code 97110. Medicare covered 64,224,019 of these. Here is what providers billed and what Medicare allowed, state by state.

$69.14Billed, national avg
$22.79Medicare allowed
3.0xBilled vs allowed
3.1xHighest vs lowest state

Providers in New Jersey billed the most for this, at $98.99. In Puerto Rico the average was $32.25. Same procedure code, same programme.

Whose price this is

These are Medicare figures. The billed column is what providers asked for. The allowed column is what Medicare agreed to pay. Neither is what an uninsured patient gets charged, and neither is what a private insurer negotiates.

The gap between the two columns is the point. A hospital billing three times what Medicare allows tells you the billed number was never a price. It was an opening position.

By state

StateBilledMedicare allowedGapServices
New Jersey$98.99$24.414.1x4,896,825
Alaska$96.85$29.743.3x152,797
Wisconsin$94.85$22.384.2x617,236
Minnesota$89.07$23.113.9x562,201
Armed Forces Pacific$76.38$21.233.6x742
Michigan$76.08$21.913.5x1,373,123
Illinois$75.37$22.333.4x2,936,095
North Dakota$74.60$23.233.2x135,247
Indiana$74.54$21.353.5x906,354
New York$73.56$24.543.0x6,808,976
Delaware$73.35$22.113.3x492,771
Florida$71.97$22.043.3x4,674,738
Virgin Islands$71.86$23.063.1x17,956
Rhode Island$70.93$23.143.1x270,236
Oregon$70.37$22.723.1x466,431
Wyoming$70.05$22.633.1x339,470
Connecticut$69.06$23.942.9x660,131
New Hampshire$68.86$23.153.0x226,095
Colorado$68.52$23.173.0x864,893
Arizona$68.29$22.013.1x1,586,171
Nevada$67.99$22.803.0x650,354
Foreign Country$67.92$22.183.1x691
District of Columbia$67.70$24.322.8x88,017
Massachusetts$67.67$23.962.8x1,521,745
Missouri$67.24$21.463.1x801,114
Virginia$67.18$22.533.0x1,759,306
Iowa$66.70$21.493.1x615,227
Texas$65.57$21.753.0x2,941,851
Maine$65.33$22.452.9x190,050
Washington$65.24$23.202.8x1,070,937
South Dakota$65.11$22.852.8x247,610
Maryland$64.83$23.192.8x1,737,901
Nebraska$64.45$21.563.0x602,656
Georgia$63.63$21.802.9x1,462,574
North Carolina$63.27$21.802.9x1,689,861
Ohio$63.23$21.403.0x1,297,658
Tennessee$62.51$21.302.9x1,359,583
Pennsylvania$62.46$22.492.8x2,802,763
Oklahoma$60.76$21.002.9x594,393
South Carolina$60.38$21.412.8x1,616,359
California$60.32$24.542.5x6,043,546
New Mexico$59.98$21.302.8x324,156
Alabama$59.80$20.612.9x792,870
Vermont$59.15$23.192.6x120,727
Kentucky$58.18$21.112.8x600,014
Montana$57.77$23.122.5x291,026
Kansas$57.53$21.542.7x572,789
Mississippi$55.76$20.692.7x912,980
Arkansas$55.47$20.972.6x820,122
Louisiana$55.06$21.572.6x1,188,531
West Virginia$54.09$20.862.6x285,436
Utah$54.05$22.062.4x529,992
Hawaii$52.22$23.852.2x278,962
Idaho$50.84$21.792.3x385,134
Unknown$46.95$21.642.2x2,328
Armed Forces Europe$46.24$22.352.1x1,606
Guam$46.23$25.051.8x8,472
Northern Mariana Islands$44.97$24.601.8x660
Puerto Rico$32.25$22.821.4x25,185

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

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