What does code 97166 cost?

Across the published hospital price files, the disclosed cash price for 97166 ranges from $40.00 to $723. 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.

97166 is the billing code hospitals use to identify "HC OT EVAL MODERATE 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.

97166

HCPCS

HC OT EVAL MODERATE COMPLEXITY

Verified from hospital fileNot a bill estimate

iDirect answer

Based on the latest published hospital price files, code 97166 (HC OT EVAL MODERATE COMPLEXITY) appears at 76 hospitals with disclosed cash prices from $40.00 to $723. 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

147

Cash

147

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 97166 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 97166 vary by about 18× across the 74 hospitals with disclosed prices here — from $40.00 to $723. Shopping around can matter.

Hospitals

152

Prices shown

$40.00

Lowest cash

$723

Highest cash

code 97166 cash price147 disclosed · 74 hospitals

$40.00median ~$247$723

Lowest cash price by hospital

Advocate Illinois Masonic Medical Center$40.00
Advocate Condell Medical Center$40.00
Advocate Good Samaritan Hospital$40.00
The Women's Hospital$54.28
Advocate South Suburban Hospital$95.00
Providence St Joseph Medical Center$123

Cash price by city

Reflects your current filters.

Cash price by city$40.00 – $434

Chicago · 2 hospitals$40.00–$376
Libertyville · 1 hospital$40.00–$225
Downers Grove · 1 hospital$40.00–$225
Newburgh · 2 hospitals$54.28–$434
Hazel Crest · 1 hospital$95.00–$225
Polson · 1 hospital$123

152 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
HC OT EVAL MODERATE COMPLEXITY Inpatient & outpatient	Endeavor Health Edward Hospital	97166 HCPCS	$709	$709	—	—
Ot eval mod complex 45 min Outpatient	Endeavor Health Edward Hospital	97166 HCPCS	—	—	$96.48 – $172	—
Hc Occupational Therapy Evaluation Moderate Complex 45 Min Inpatient & outpatient	University of Chicago Medical Center	97166 HCPCS	—	—	—	—
Ot eval mod complex 45 min Outpatient	University of Chicago Medical Center	97166 HCPCS	—	—	—	—
OT EVAL MOD COMP PER 15 PA ONLY Outpatient	Advocate Illinois Masonic Medical Center	97166 CPT	$190	$95.00	$74.86 – $469	$128
OT EVAL MOD COMPLEXITY Outpatient	Advocate Illinois Masonic Medical Center	97166 CPT	$450	$225	$150 – $469	$128
PEDS OT-EVAL MOD COMP/15 PA ONLY Outpatient	Advocate Illinois Masonic Medical Center	97166 CPT	$80.00	$40.00	$31.52 – $469	$128
HB OT EVALUATION MODERATE COMPLEX 45 MINS Inpatient & outpatient	Endeavor Health Swedish Hospital	97166 HCPCS	$376	$376	—	—
PEDS OT EVAL-MODERATE COMPLEXITY Outpatient	Advocate Condell Medical Center	97166 CPT	$450	$225	$150 – $360	—
PEDS OT-EVAL MOD COMP/15 PA ONLY Outpatient	Advocate Condell Medical Center	97166 CPT	$80.00	$40.00	$31.52 – $295	—
OT EVAL MOD COMPLEXITY Outpatient	Advocate Condell Medical Center	97166 CPT	$450	$225	$150 – $360	—
OT EVAL MOD COMP PER 15 PA ONLY Outpatient	Advocate Good Samaritan Hospital	97166 CPT	$190	$95.00	$74.86 – $469	—
OT EVAL MOD COMPLEXITY Outpatient	Advocate Good Samaritan Hospital	97166 CPT	$450	$225	$150 – $469	—
PEDS OT-EVAL MOD COMP/15 PA ONLY Outpatient	Advocate Good Samaritan Hospital	97166 CPT	$80.00	$40.00	$31.52 – $469	—
OT EVAL MOD COMP PER 15 PA ONLY Outpatient	Advocate South Suburban Hospital	97166 CPT	$190	$95.00	$74.86 – $469	—
OT EVAL MOD COMPLEXITY Outpatient	Advocate South Suburban Hospital	97166 CPT	$450	$225	$150 – $469	—
HC OT EVALUATION 45 MIN MOD COMPLEX Inpatient	Deaconess Gateway Hospital	97166 CPT	$527	$174	$174 – $464	—
HC OCCUPATIONAL THERAPY EVALUATION, MODERATE COMPLEXITY Outpatient	Froedtert Menomonee Falls Hospital	97166 CPT	$459	$252	$97.60 – $413	—
HC TELEHEALTH OCCUPATIONAL THERAPY EVALUATION, MODERATE COMPLEXITY Outpatient	Froedtert Menomonee Falls Hospital	97166 CPT	$472	$260	$97.60 – $425	—
OT EVAL MOD COMPLEXITY Inpatient	Aurora BayCare Medical Center	97166 CPT	$480	$240	$288 – $408	—
OT EVAL MOD COMPLEXITY Inpatient	Aurora Medical Center Burlington	97166 CPT	$480	$240	$288 – $408	—
97166 OT EVAL OP 45 MIN OT IP Inpatient	Munson Healthcare Charlevoix Hospital	97166 CPT	$293	$249	$234 – $293	—
Moderate Complexity Evaluation - OT Untimed Charges Inpatient	Munson Healthcare Charlevoix Hospital	97166 CPT	$293	$249	$234 – $293	—
OT Eval OP 45 Min - OT Inpatient	Munson Healthcare Charlevoix Hospital	97166 CPT	$293	$249	$234 – $293	—
OT 97166 OT EVAL MOD COMPLEX 45 M OP Inpatient	Munson Healthcare Charlevoix Hospital	97166 CPT	$293	$249	$234 – $293	—

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 97166 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 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 Holy Family Memorial Hospital Froedtert Community Hospital - Mequon Froedtert Community Hospital - New Berlin Kalkaska Memorial Health Center Paul Oliver Memorial Hospital Munson Healthcare Grayling Munson Healthcare Cadillac Henderson Hospital Deaconess Gibson Hospital Deaconess Union County Hospital The Women's Hospital Deaconess Illinois Medical Center Community Hospital of Bremen Three Rivers Health 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 St Patrick Hospital - Broadway Campus Providence Hood River Memorial Hospital Providence Medford Medical Center Providence Milwaukie Hospital Providence Newberg Medical Center Providence Portland Medical Center Providence St Vincent Medical Center Providence Seaside Hospital Berger Hospital Doctors Hospital Dublin Methodist Hospital Grady Memorial Hospital Grant Medical Center Grove City Methodist Hospital Hardin Memorial Hospital Mansfield Hospital Providence Willamette Falls Medical Center Covenant Medical Center Covenant Hospital Plainview Grace Surgical Hospital Covenant Specialty Hospital M Health Fairview Lakes Medical Center M Health Fairview Ridges Hospital Marion General Hospital O'Bleness Hospital Pickerington Methodist Hospital Riverside Methodist Hospital Shelby Hospital

Code 97166: frequently asked

What does code 97166 cost?: Across the published hospital price files, the disclosed cash price for 97166 ranges from $40.00 to $723. 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 97166?: 97166 is the billing code hospitals use to identify "HC OT EVAL MODERATE 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.

All CPT / HCPCS codes Browse hospitals How to read this data

Hospitals publishing code 97166 by state

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