Acupuncture with electrical stimulation, initial 15 minutes
Medicare pricing data for 805 providers across 36 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
Acupuncture with electrical stimulation, initial 15 minutes (HCPCS code 97813) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $47.40, but hospitals typically charge $111.65 — 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 $47.40, your out-of-pocket cost would be approximately $9.48. 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 $36.98 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $51 | $125 | 98 | 18,037 | +8.3% |
| Maryland | $50 | $64 | 29 | 4,804 | +6.0% |
| California | $50 | $114 | 104 | 10,435 | +4.5% |
| New Jersey | $49 | $153 | 82 | 8,464 | +4.1% |
| Pennsylvania | $47 | $119 | 47 | 3,120 | +0.1% |
| Connecticut | $46 | $69 | 6 | 1,129 | -3.1% |
| Nevada | $45 | $79 | 4 | 1,019 | -4.9% |
| South Dakota | $45 | $94 | 1 | 177 | -5.1% |
| Colorado | $45 | $94 | 23 | 1,511 | -5.3% |
| Massachusetts | $45 | $84 | 14 | 762 | -6.1% |
| Delaware | $44 | $114 | 5 | 712 | -6.2% |
| Illinois | $44 | $90 | 25 | 2,657 | -6.4% |
| Michigan | $44 | $104 | 24 | 1,405 | -7.1% |
| Virginia | $44 | $130 | 13 | 887 | -8.0% |
| Oregon | $43 | $116 | 7 | 226 | -8.3% |
| Ohio | $43 | $115 | 25 | 1,169 | -8.8% |
| Florida | $43 | $84 | 37 | 4,814 | -8.9% |
| Georgia | $43 | $108 | 7 | 484 | -9.1% |
| Indiana | $43 | $87 | 7 | 84 | -9.4% |
| Kansas | $43 | $70 | 2 | 36 | -9.5% |
| Louisiana | $43 | $95 | 2 | 128 | -9.6% |
| Texas | $42 | $119 | 23 | 667 | -10.8% |
| Minnesota | $42 | $137 | 68 | 805 | -11.4% |
| Nebraska | $42 | $90 | 2 | 123 | -11.4% |
| Washington | $41 | $106 | 10 | 532 | -12.5% |
| South Carolina | $41 | $55 | 5 | 1,433 | -12.7% |
| Wisconsin | $41 | $124 | 28 | 1,892 | -13.3% |
| Kentucky | $41 | $117 | 4 | 250 | -13.7% |
| North Carolina | $40 | $103 | 11 | 542 | -15.9% |
| Iowa | $40 | $44 | 12 | 210 | -16.3% |
| Tennessee | $40 | $74 | 4 | 278 | -16.3% |
| Arizona | $39 | $110 | 27 | 2,154 | -17.6% |
| Missouri | $38 | $72 | 8 | 54 | -18.9% |
| Maine | $37 | $78 | 9 | 139 | -22.4% |
| Alabama | $36 | $65 | 2 | 69 | -24.8% |
| Idaho | $34 | $76 | 2 | 86 | -28.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber