Evaluation for wheelchair, each 15 minutes
Medicare pricing data for 4,673 providers across 50 states
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
Evaluation for wheelchair, each 15 minutes (HCPCS code 97542) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $24.53, but hospitals typically charge $57.98 — a 2.4x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $24.53, your out-of-pocket cost would be approximately $4.91. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $19.04 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $33 | $80 | 4 | 69 | +35.3% |
| New York | $27 | $74 | 352 | 7,019 | +11.6% |
| Oklahoma | $27 | $80 | 29 | 583 | +8.5% |
| Maryland | $26 | $57 | 141 | 2,504 | +6.9% |
| New Jersey | $26 | $59 | 419 | 7,394 | +6.4% |
| Connecticut | $26 | $55 | 52 | 1,100 | +6.2% |
| Washington | $26 | $50 | 106 | 3,282 | +5.7% |
| District of Columbia | $26 | $56 | 14 | 777 | +4.9% |
| Hawaii | $26 | $52 | 14 | 172 | +4.6% |
| California | $26 | $62 | 288 | 6,645 | +4.2% |
| Massachusetts | $26 | $59 | 78 | 1,084 | +4.2% |
| Nevada | $26 | $82 | 40 | 4,463 | +4.0% |
| South Dakota | $25 | $55 | 13 | 463 | +3.4% |
| Rhode Island | $25 | $44 | 10 | 118 | +1.8% |
| Minnesota | $25 | $64 | 100 | 2,824 | +1.2% |
| Colorado | $25 | $63 | 102 | 2,606 | +1.2% |
| Montana | $25 | $53 | 22 | 1,109 | +1.1% |
| Delaware | $25 | $58 | 20 | 335 | +0.7% |
| Illinois | $25 | $61 | 212 | 6,462 | +0.0% |
| North Dakota | $24 | $55 | 13 | 218 | -0.2% |
| Texas | $24 | $63 | 245 | 5,702 | -0.4% |
| New Hampshire | $24 | $51 | 33 | 1,083 | -0.5% |
| Oregon | $24 | $53 | 39 | 521 | -0.9% |
| Virginia | $24 | $52 | 168 | 5,463 | -1.2% |
| Michigan | $24 | $77 | 112 | 1,838 | -1.2% |
| Arizona | $24 | $60 | 80 | 1,096 | -1.6% |
| New Mexico | $24 | $45 | 21 | 253 | -1.7% |
| Pennsylvania | $24 | $55 | 228 | 4,857 | -2.2% |
| Maine | $24 | $55 | 27 | 375 | -2.2% |
| Nebraska | $24 | $58 | 41 | 1,180 | -2.9% |
| Florida | $24 | $58 | 275 | 6,321 | -3.2% |
| Missouri | $24 | $61 | 89 | 3,722 | -3.9% |
| Ohio | $24 | $60 | 135 | 3,281 | -3.9% |
| Iowa | $24 | $50 | 35 | 603 | -4.0% |
| Wyoming | $24 | $44 | 12 | 162 | -4.0% |
| Wisconsin | $24 | $61 | 125 | 1,993 | -4.0% |
| Georgia | $24 | $51 | 143 | 3,687 | -4.1% |
| Louisiana | $23 | $62 | 31 | 241 | -4.4% |
| Mississippi | $23 | $57 | 44 | 467 | -4.5% |
| Idaho | $23 | $44 | 15 | 102 | -4.5% |
| Utah | $23 | $38 | 42 | 8,865 | -4.7% |
| Arkansas | $23 | $57 | 23 | 481 | -4.8% |
| Tennessee | $23 | $58 | 129 | 2,232 | -5.2% |
| South Carolina | $23 | $50 | 107 | 1,853 | -5.5% |
| Indiana | $23 | $55 | 133 | 3,639 | -5.7% |
| Kansas | $23 | $58 | 49 | 1,594 | -5.8% |
| North Carolina | $23 | $48 | 134 | 3,669 | -6.1% |
| Alabama | $23 | $58 | 23 | 174 | -6.4% |
| Kentucky | $23 | $54 | 74 | 1,369 | -7.6% |
| West Virginia | $22 | $33 | 19 | 629 | -9.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber