Price Checker / CPT 97130
CPT 97130 — Ther ivntj ea addl 15 min
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$18
What Medicare pays in a hospital/ASC setting
$21
What Medicare pays in a physician's office
$328
Based on 39 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 97130
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Castro County Hospital District dba Plains Memorial Hospital Dimmitt, TX | $3,815 | — | 15313% |
| HealthSource Saginaw , MI | — | — | 8455% |
| HealthSource Saginaw , MI | — | — | 8455% |
| Penn State Health Rehabilitation Hospital , PA | $116 | — | 4487% |
| Bienville Medical Center , LA | $757 | $454 | 3498% |
| Ste Genevieve County Memorial Hospital , MO | $508 | $254 | 2314% |
| Covenant Rehabilitation Hospital of Lubbock, LLC Lubbock, TX | $65 | — | 1361% |
| Baylor - Dallas Dallas, TX | — | — | 1312% |
| Baylor - Fort Worth Fort Worth, TX | — | — | 1312% |
| Baylor - Frisco Frisco, TX | — | — | 1312% |
| Baylor - Lakeway Lakeway, TX | — | — | 1312% |
| Summa Rehab Hospital, LLC Akron, OH | $105 | — | 1064% |
| Baton Rouge Rehab Hospital , LA | $237 | $166 | 1027% |
| SOUTHERN VIRGINIA MEDICAL CENTER , VA | $235 | — | 1017% |
| RAPPAHANNOCK GENERAL HOSPITAL Kilmarnock, VA | $213 | — | 912% |
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About CPT 97130
CPT code 97130 refers to “Ther ivntj ea addl 15 min”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $18 in a facility (hospital or ambulatory surgery center) and $21in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.