Price Checker / CPT 97164
How much does Pt Re-eval Est Plan Care cost?
CPT 97164 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is about 2.4x the fair price. You have grounds to ask for a reduction.
Fair price
$210–$250
What this should cost
With insurance
~$380
Typical out-of-pocket
Overcharged if over
$310
Push back above this
The average hospital charge of $543 is $313 over the fair price (about 2.4x the fair rate).
What hospitals charge for Pt Re-eval Est Plan Care
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Stonewall Jackson Hospital , WV | — | — | 6603% |
| UM Capital Region Medical Center Largo, MD | $1,809 | — | 2581% |
| HealthSource Saginaw SAGINAW, MI | — | — | 2568% |
| UM Upper Chesapeake Behavior Health Pavilion at Aberdeen , MD | $1,468 | — | 2075% |
| UM Shore Medical Center at Chestertown Chestertown, MD | $1,054 | — | 1462% |
| UM Upper Chesapeake Medical Center Aberdeen Aberdeen, MD | $944 | — | 1300% |
| UM R Adams Cowley Shock Trauma Center Baltimore, MD | $744 | — | 1003% |
| MEDICAL CITY MENTAL HEALTH AND WELLNESS CENTER - ALLIANCE FORT WORTH, TX | $383 | — | 468% |
| Pennsylvania Psychiatric Institute Harrisburg, PA | $418 | — | 396% |
| Covenant Rehabilitation Hospital of Lubbock, LLC Lubbock, TX | $260 | — | 356% |
| Summa Rehab Hospital, LLC Akron, OH | $260 | — | 263% |
| Baptist Health Rehabilitation Institute-Little Rock , AR | $235 | $59 | 248% |
| Saint Barnabas Behavioral Health Center TOMS RIVER, NJ | $211 | — | 213% |
| Elkhorn Valley Rehabilitation Hospital, LLC , WY | $260 | — | 122% |
| Lafayette Regional Rehabilitation Hospital LLC Lafayette, IN | $260 | — | 107% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Pt Re-eval Est Plan Care
CPT code 97164 refers to pt re-eval est plan care (billing description: "Pt re-eval est plan care"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $67 in a facility (hospital or surgery center) and $67 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.