What does code 97163 cost?

Across the published hospital price files, the disclosed cash price for 97163 ranges from $42.50 to $800. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Will this be my final bill?

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

97163 is the billing code hospitals use to identify "HC PT EVAL HIGH COMPLEXITY" on their published price files. We use it to line up the same service across different hospitals.

Why do prices for this code differ between hospitals?

Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.

What this page is not

It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.

97163

HCPCS

HC PT EVAL HIGH COMPLEXITY

Verified from hospital fileNot a bill estimate

iDirect answer

Based on the latest published hospital price files, code 97163 (HC PT EVAL HIGH COMPLEXITY) appears at 49 hospitals with disclosed cash prices from $42.50 to $800. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Published-price availability

hospitals publish a price

list this service without a published price

112

Cash

112

List

Negotiated

Allowed

A blank price (“—”) means a hospital names this service but did not publish a dollar amount — it is not a free service or a $0 price.

Compare 97163 prices

Filter by hospital, city, setting, or payer — the summary and charts update with your filters.

Based on hospital-published prices verified from each hospital’s own file. Coverage expands as data is verified.

Published cash prices for code 97163 vary by about 19× across the 47 hospitals with disclosed prices here — from $42.50 to $800. Shopping around can matter.

Hospitals

117

Prices shown

$42.50

Lowest cash

$800

Highest cash

code 97163 cash price112 disclosed · 47 hospitals

$42.50median ~$260$800

Lowest cash price by hospital

Cash price by city

Reflects your current filters.

Cash price by city$42.50 – $434

Downers Grove · 1 hospital$42.50–$213
Newburgh · 2 hospitals$54.28–$434
Libertyville · 1 hospital$113–$213
Hazel Crest · 1 hospital$113–$213
Polson · 1 hospital$154
Tarzana · 1 hospital$154–$193

117 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
HC PT EVAL HIGH COMPLEXITY Inpatient & outpatient	Endeavor Health Edward Hospital	97163 HCPCS	$757	$757	—	—
Pt eval high complex 45 min Outpatient	Endeavor Health Edward Hospital	97163 HCPCS	—	—	$94.04 – $183	—
Hc Physical Therapy High Complex 45 Min Inpatient & outpatient	University of Chicago Medical Center	97163 HCPCS	—	—	—	—
Pt eval high complex 45 min Outpatient	University of Chicago Medical Center	97163 HCPCS	—	—	—	—
PT EVAL HIGH COMPLEXITY Outpatient	Advocate Illinois Masonic Medical Center	97163 CPT	$425	$213	$146 – $469	—
HB PT EVALUATION HIGH COMPLEX 45 MINS Inpatient & outpatient	Endeavor Health Swedish Hospital	97163 HCPCS	$402	$402	—	—
PEDS PT EVAL HIGH COMPLEXITY Outpatient	Advocate Condell Medical Center	97163 CPT	$425	$213	$146 – $340	—
PT EVAL HIGH COMPLEXITY Outpatient	Advocate Condell Medical Center	97163 CPT	$425	$213	$146 – $340	—
PT EVAL HIGH COMP PER 15 PA ONLY Outpatient	Advocate Condell Medical Center	97163 CPT	$225	$113	$88.65 – $295	—
PEDS PT EVAL HGH COMP/15 PA ONLY Outpatient	Advocate Good Samaritan Hospital	97163 CPT	$85.00	$42.50	$33.49 – $469	—
PT EVAL HIGH COMPLEXITY Outpatient	Advocate Good Samaritan Hospital	97163 CPT	$425	$213	$146 – $469	—
PEDS PT EVAL HIGH COMPLEXITY Outpatient	Advocate Good Samaritan Hospital	97163 CPT	$425	$213	$146 – $469	—
PT EVAL HIGH COMPLEXITY Outpatient	Advocate South Suburban Hospital	97163 CPT	$425	$213	$146 – $469	—
PT EVAL HIGH COMP PER 15 PA ONLY Outpatient	Advocate South Suburban Hospital	97163 CPT	$225	$113	$88.65 – $469	—
HC PT EVALUATION 15 MIN II HIGH COMPLEX Inpatient	Deaconess Gateway Hospital	97163 CPT	$632	$209	$209 – $556	—
HC PT EVALUATION 30 MIN HIGH COMPLEX Inpatient	Deaconess Gateway Hospital	97163 CPT	$632	$209	$209 – $556	—
HC PT EVALUATION 105 MIN HIGH COMPLX Inpatient	Deaconess Gateway Hospital	97163 CPT	$632	$209	$209 – $556	—
HC PT EVALUATION 120 MIN HIGH COMPLX Inpatient	Deaconess Gateway Hospital	97163 CPT	$632	$209	$209 – $556	—
PT 97163 THERAPY EVALUATION - 60 MIN/5 Inpatient	Memorial Hospital of South Bend	97163 CPT	$553	$359	$111 – $453	—
HC PHYSICAL THERAPY EVALUATION, HIGH COMPLEXITY Outpatient	Froedtert Menomonee Falls Hospital	97163 CPT	$545	$300	$95.13 – $491	—
HC TELEHEALTH PHYSICAL THERAPY EVALUATION, HIGH COMPLEXITY Outpatient	Froedtert Menomonee Falls Hospital	97163 CPT	$515	$283	$95.13 – $464	—
PT EVAL HIGH COMPLEXITY Inpatient	Aurora BayCare Medical Center	97163 CPT	$620	$310	$372 – $527	—
PT EVAL HIGH COMPLEXITY Inpatient	Aurora Medical Center Burlington	97163 CPT	$620	$310	$372 – $527	—
97163 PT EVAL 45 MIN PT IP Inpatient	Munson Healthcare Charlevoix Hospital	97163 CPT	$432	$367	$346 – $432	—
High Complexity Evaluation - PT Untimed Charges Inpatient	Munson Healthcare Charlevoix Hospital	97163 CPT	$431	$366	$345 – $431	—

How to read these prices

Cash price: The discounted self-pay price for paying directly, without insurance.
List price: The hospital’s full undiscounted charge — rarely what anyone pays.
Negotiated rate: A rate for a specific insurer and plan; your share depends on your benefits.
Allowed amount: A historical reference for what was actually allowed, where disclosed.

Hospitals that publish 97163 prices

Open a hospital to see this code in the context of its full published prices.

Endeavor Health Edward Hospital University of Chicago Medical Center Advocate Illinois Masonic Medical Center Endeavor Health Swedish Hospital Advocate Condell Medical Center Advocate Good Samaritan Hospital Advocate South Suburban Hospital Deaconess Gateway Hospital Memorial Hospital of South Bend Froedtert Menomonee Falls Hospital Aurora BayCare Medical Center Aurora Medical Center Burlington Munson Healthcare Charlevoix Hospital Munson Healthcare Manistee Hospital Aurora Medical Center Bay Area Aurora Medical Center Fond du Lac Aurora Medical Center Grafton Aurora Medical Center Kenosha Aurora Lakeland Medical Center Froedtert West Bend Hospital Froedtert Holy Family Memorial Hospital Froedtert Community Hospital - Mequon Froedtert Community Hospital - New Berlin Froedtert Community Hospital - Oak Creek Kalkaska Memorial Health Center Paul Oliver Memorial Hospital Munson Healthcare Grayling Henderson Hospital Deaconess Gibson Hospital Deaconess Union County Hospital The Women's Hospital Deaconess Illinois Medical Center Community Hospital of Bremen Providence Alaska Medical Center Providence Kodiak Island Medical Center Stanford Health Care Stanford Health Care Tri-Valley Providence Seward Hospital Providence Valdez Medical Center St Elias Specialty Hospital Healdsburg Hospital Providence Cedars-Sinai Tarzana Medical Center Providence Holy Cross Medical Center Providence Little Co of Mary Med Center San Pedro Providence Little Company of Mary Med Center Torrance Providence Saint John's Health Center Providence Saint Joseph Medical Center Providence St Joseph Medical Center Jefferson Abington Hospital

Code 97163: frequently asked

What does code 97163 cost?: Across the published hospital price files, the disclosed cash price for 97163 ranges from $42.50 to $800. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Will this be my final bill?: Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.
What is code 97163?: 97163 is the billing code hospitals use to identify "HC PT EVAL HIGH COMPLEXITY" on their published price files. We use it to line up the same service across different hospitals.
Why do prices for this code differ between hospitals?: Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.
What this page is not: It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.

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Hospitals publishing code 97163 by state

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