CPT 97164 Physical Therapy/Rehab
Pt re-eval est plan care Cost
Body System: Musculoskeletal
Medicare Facility Rate
$67
CMS PFS CY2026
Medicare Non-Facility Rate
$67
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.96
Work RVU
1.05
Facility PE RVU
0.01
Malpractice RVU
2.02
Total RVU
Cost by Location
| Location | Medicare Rate | Est. Commercial |
|---|---|---|
| AK — ALASKA | $86 | $112 — $172 |
| AL — ALABAMA | $63 | $82 — $127 |
| AR — ARKANSAS | $63 | $81 — $125 |
| AZ — ARIZONA | $67 | $87 — $133 |
| CA — BAKERSFIELD | $72 | $93 — $143 |
| CA — CHICO | $72 | $93 — $143 |
| CA — EL CENTRO | $72 | $93 — $143 |
| CA — FRESNO | $72 | $93 — $143 |
| CA — HANFORD-CORCORAN | $72 | $93 — $143 |
| CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) | $75 | $98 — $151 |
| CA — MADERA | $72 | $93 — $143 |
| CA — MERCED | $72 | $93 — $143 |
| CA — MODESTO | $72 | $93 — $143 |
| CA — NAPA | $81 | $105 — $162 |
| CA — OXNARD-THOUSAND OAKS-VENTURA | $75 | $98 — $150 |
| CA — REDDING | $72 | $93 — $143 |
| CA — REST OF CALIFORNIA | $72 | $93 — $143 |
| CA — RIVERSIDE-SAN BERNARDINO-ONTARIO | $72 | $93 — $143 |
| CA — SACRAMENTO-ROSEVILLE-FOLSOM | $75 | $97 — $149 |
| CA — SALINAS | $74 | $97 — $149 |
Frequently Asked Questions
How much does Pt re-eval est plan care cost?
The Medicare facility rate is $67. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Pt re-eval est plan care cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $67.