97802

Therapy procedure for nutrition management, each 15 minutes

Medicare pricing data for 4,309 providers across 52 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

Therapy procedure for nutrition management, each 15 minutes (HCPCS code 97802) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $30.99, but hospitals typically charge $78.24 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.20

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $30.99, your out-of-pocket cost would be approximately $6.20. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$30.99
Average Hospital Charge
$78.24
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$78.24
Medicare Allowed$30.99
Medicare Payment$30.99

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $30.99 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$37$11323596+20.0%
New York$34$10032415,280+9.5%
New Jersey$34$761919,828+8.7%
California$34$9032718,171+8.6%
District of Columbia$34$87141,010+8.6%
Maryland$33$731124,541+5.8%
Massachusetts$33$981647,462+5.1%
Connecticut$32$78551,725+4.7%
Rhode Island$31$61511,525+1.5%
Washington$31$891363,838+1.0%
Colorado$31$67521,842-0.0%
Illinois$31$751859,991-0.4%
South Dakota$31$783146-0.8%
Virginia$31$57834,745-1.2%
Nevada$31$78483,989-1.2%
New Hampshire$31$93301,069-1.2%
Wyoming$31$8311662-1.3%
Minnesota$31$1081613,650-1.4%
Montana$31$6118550-1.5%
Florida$30$6515111,771-1.8%
Puerto Rico$30$4036488-1.9%
Oregon$30$94721,686-2.0%
Pennsylvania$30$7123510,939-2.3%
North Carolina$30$8524010,936-2.5%
Arizona$30$641246,717-3.1%
North Dakota$30$10923438-3.7%
Michigan$30$66572,147-4.1%
Wisconsin$30$1151073,368-4.3%
Texas$30$6825413,675-4.5%
Missouri$30$77481,833-4.7%
Utah$29$6532966-4.8%
Indiana$29$65773,111-5.0%
Kansas$29$63383,386-5.6%
Delaware$29$57211,189-5.6%
South Carolina$29$64311,665-5.8%
Iowa$29$12318835-5.8%
Georgia$29$65652,971-5.9%
Maine$29$5218369-5.9%
Hawaii$29$72391,534-6.0%
Ohio$29$721885,105-6.3%
Kentucky$29$64351,064-6.4%
Tennessee$29$90663,510-7.1%
Oklahoma$29$62493,746-7.2%
Alabama$29$64381,754-7.3%
Nebraska$29$86321,267-7.8%
Louisiana$29$65441,296-8.0%
Vermont$28$9717190-8.9%
New Mexico$28$7216626-9.1%
Mississippi$28$6214622-10.0%
Arkansas$28$55431,216-10.9%
Idaho$27$59461,734-13.1%
West Virginia$26$6612347-16.5%

⚠️ 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