Price Checker / CPT 97165
How much does Ot Evaluation Low Complex 30 Min cost?
CPT 97165 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is roughly 7.5x the fair price. This is well above fair — push back or dispute it.
Fair price
$340–$400
What this should cost
With insurance
~$550
Typical out-of-pocket
Overcharged if over
$500
Push back above this
The average hospital charge of $2,768 is $2,398 over the fair price (about 7.5x the fair rate).
What hospitals charge for Ot Evaluation Low Complex 30 Min
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Long Island Jewish Forest Hills , NY | — | $369 | 25273% |
| South Shore University Hospital , NY | — | $369 | 25273% |
| Phelps Hospital SLEEPY HOLLOW, NY | — | $369 | 24529% |
| Rehabilitation Hospital of Rhode Island , RI | $5,088 | $5,088 | 4960% |
| UM Shore Medical Center at Cambridge , MD | $1,826 | — | 1716% |
| UM Upper Chesapeake Behavior Health Pavilion at Aberdeen , MD | $1,816 | — | 1706% |
| HealthSource Saginaw SAGINAW, MI | — | — | 1690% |
| UM Capital Region Medical Center Largo, MD | $1,530 | — | 1421% |
| UM Charles Regional Medical Center La Plata, MD | $1,237 | — | 1131% |
| UM Rehabilitation & Orthopaedic Institute Baltimore, MD | $1,220 | — | 1114% |
| UM Shore Medical Center at Chestertown Chestertown, MD | $1,103 | — | 997% |
| UM Upper Chesapeake Medical Center Aberdeen Aberdeen, MD | $973 | — | 868% |
| Penn State Health Rehabilitation Hospital , PA | $330 | — | 860% |
| Penn Medicine Good Shepherd Rehabilitation Specialty Hospital , PA | $791 | — | 529% |
| MEDICAL CITY MENTAL HEALTH AND WELLNESS CENTER - ALLIANCE FORT WORTH, TX | $551 | — | 448% |
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 Ot Evaluation Low Complex 30 Min
CPT code 97165 refers to ot evaluation low complex 30 min (billing description: "Ot eval low complex 30 min"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $101 in a facility (hospital or surgery center) and $101 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.