Price Checker / CPT 97168
How much does Ot Re-eval Est Plan Care cost?
CPT 97168 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is about above the fair price. You have grounds to ask for a reduction.
Fair price
$220–$260
What this should cost
With insurance
~$430
Typical out-of-pocket
Overcharged if over
$330
Push back above this
The average hospital charge of $411 is $171 over the fair price.
What hospitals charge for Ot 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 |
|---|---|---|---|
| Wyoming County Community Health System Warsaw, NY | $129 | — | 3551% |
| HealthSource Saginaw SAGINAW, MI | — | — | 2529% |
| UM Shore Medical Center at Cambridge , MD | $1,027 | — | 1400% |
| UM Upper Chesapeake Behavior Health Pavilion at Aberdeen , MD | $1,021 | — | 1392% |
| Penn State Health Rehabilitation Hospital , PA | $136 | — | 1309% |
| UM Upper Chesapeake Medical Center Aberdeen Aberdeen, MD | $730 | — | 966% |
| MEDICAL CITY MENTAL HEALTH AND WELLNESS CENTER - ALLIANCE FORT WORTH, TX | $372 | — | 443% |
| Pennsylvania Psychiatric Institute Harrisburg, PA | $416 | — | 386% |
| Baptist Health Rehabilitation Institute-Little Rock , AR | $235 | $59 | 243% |
| Unity Psychiatric Care in Clarksville Clarksville, TN | $146 | — | 113% |
| Unity Psychiatric Care in Columbia Columbia, TN | $146 | — | 113% |
| Unity Psychiatric Care in Huntsville Huntsville, AL | $146 | — | 113% |
| Unity Psychiatric Care in Martin Martin, TN | $146 | — | 113% |
| Unity Psychiatric Care in Memphis Memphis, TN | $146 | — | 113% |
| Weslaco Regional Rehabilitation Hospital, LLC Weslaco, TX | $260 | — | 75% |
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 Re-eval Est Plan Care
CPT code 97168 refers to ot re-eval est plan care (billing description: "Ot re-eval est plan care"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $68 in a facility (hospital or surgery center) and $68 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.