97022

Application of whirlpool therapy

Medicare pricing data for 2,687 providers across 47 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Application of whirlpool therapy (HCPCS code 97022) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.08, but hospitals typically charge $47.72 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.42

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.08, your out-of-pocket cost would be approximately $2.42. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.08
Average Hospital Charge
$47.72
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$47.72
Medicare Allowed$12.08
Medicare Payment$9.35

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $9.35 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$16$3817613,887+31.1%
California$13$381418,513+11.4%
Texas$13$55916,849+10.1%
District of Columbia$13$61465+9.9%
New Jersey$13$461295,424+5.6%
Rhode Island$13$7623831+5.3%
Connecticut$13$3721659+4.6%
Illinois$13$441598,419+4.1%
Maryland$12$47401,902-1.0%
Pennsylvania$12$471816,210-1.7%
Hawaii$12$40379-1.8%
Virginia$12$50421,101-3.9%
Delaware$12$68404,225-4.0%
Washington$12$49563,496-4.5%
New Hampshire$12$654129-4.6%
Florida$11$5816910,397-5.0%
Massachusetts$11$4327815-5.0%
Nevada$11$6010183-5.2%
Colorado$11$5426735-5.3%
South Carolina$11$38743,625-5.7%
Michigan$11$46933,067-5.8%
Montana$11$30189-6.0%
Minnesota$11$7056594-7.0%
Kentucky$11$49321,803-7.1%
Oregon$11$419837-7.5%
Arizona$11$40702,735-7.5%
North Dakota$11$39465-8.3%
Ohio$11$53772,396-8.4%
Wisconsin$11$991061,149-8.4%
Georgia$11$501154,378-8.6%
North Carolina$11$451186,709-9.6%
Missouri$11$56161,034-10.2%
Nebraska$11$4619812-10.2%
Tennessee$11$57772,561-10.3%
Utah$11$3328922-10.4%
Indiana$11$4450818-10.8%
Iowa$11$5617195-10.8%
Idaho$11$31171,759-10.9%
Kansas$11$46301,802-10.9%
South Dakota$11$3411761-11.3%
Louisiana$11$55954,754-11.5%
Maine$11$451239-12.3%
Oklahoma$11$39121,203-12.9%
Alabama$10$45814,337-13.2%
Arkansas$10$55572,411-13.7%
West Virginia$10$4124273-13.9%
Mississippi$10$41433,919-15.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber