How much does Physical therapy evaluation, low complexity cost in Virginia?
CPT 97161 — the fair price, every hospital's price, and the Medicare benchmark for Virginia.
Estimates only. Educational estimates from public Medicare
benchmarks and hospital-published prices — not a guarantee, and not legal, medical, or financial advice.
97161 Physical therapy evaluation, low complexity
Market typical price
$212
60 facilities · typical range $158 – $305 · 2.2× Medicare PFS
Typical
$212
Medicare $98
$74 lowboxed = typical rangehigh $1,164
What Medicare paysⓘ
$98
Market typical
$212
Cash / self-pay price
$216
Prices near you — 60 facilities, lowest first
| Facility | Type | Price | vs Medicare | Quality |
|---|---|---|---|---|
| Ballad Health Lonesome Pine Hospital (Big Stone Gap) lowest | Hospital | $74cash | 0.8× | ★★★★★ |
| Ballad Health Smyth County Community Hospital (Marion) | Hospital | $74cash | 0.8× | ★★★★★ hip/knee complications 4.4% |
| Ballad Health Russell County Hospital (Lebanon) | Hospital | $74cash | 0.8× | ★★★★★ |
| Ballad Health Johnston Memorial Hospital (Abingdon) | Hospital | $74cash | 0.8× | ★★★★★ hip/knee complications 6.2% |
| Sentara Williamsburg Regional Medical Center (Williamsburg) | Hospital | $102negotiated | 1.0× | ★★★★★ hip/knee complications 5.6% |
| Mary Washington Hospital (Fredericksburg) | Hospital | $125cash | 1.3× | ★★★★★ hip/knee complications 3.9% |
| Stafford Hospital (Stafford) | Hospital | $125cash | 1.3× | ★★★★★ |
| Riverside Regional Medical Center (Newport News) | Hospital | $130negotiated | 1.3× | ★★★★★ |
| Riverside Walter Reed Hospital (Gloucester) | Hospital | $130negotiated | 1.3× | ★★★★★ hip/knee complications 2.9% |
| Riverside Doctors' Hospital of Williamsburg (Williamsburg) | Hospital | $130negotiated | 1.3× | ★★★★★ hip/knee complications 2.5% |
| Carilion Roanoke Memorial Hospital (Roanoke) | Hospital | $138cash | 1.4× | ★★★★★ hip/knee complications 7.9% |
| Carilion New River Valley Medical Center (Christiansburg) | Hospital | $138cash | 1.4× | ★★★★★ |
| UVA Health Culpeper Medical Center (Culpeper) | Hospital | $150cash | 1.5× | ★★★★★ |
| UVA Health Haymarket Medical Center (Haymarket) | Hospital | $158cash | 1.6× | ★★★★★ |
| UVA Health Prince William Medical Center (Manassas) | Hospital | $158cash | 1.6× | ★★★★★ |
| Twin County Regional Hospital (Galax) | Hospital | $159cash | 1.6× | ★★★★★ |
| Sentara RMH Medical Center (Harrisonburg) | Hospital | $164cash | 1.7× | ★★★★★ hip/knee complications 3.9% |
| Sentara Martha Jefferson Hospital (Charlottesville) | Hospital | $164cash | 1.7× | ★★★★★ hip/knee complications 4.9% |
| Chesapeake Regional Medical Center (Chesapeake) | Hospital | $170cash | 1.7× | ★★★★★ hip/knee complications 4.6% |
| VCU Medical Center (Richmond) | Hospital | $184negotiated | 1.9× | ★★★★★ hip/knee complications 4.8% |
| Augusta Health (Fishersville) | Hospital | $208cash | 2.1× | ★★★★★ hip/knee complications 4.3% |
| Inova Alexandria Hospital (Alexandria) | Hospital | $212cash | 2.2× | ★★★★★ hip/knee complications 4.0% |
| Inova Fair Oaks Hospital (Fairfax) | Hospital | $212cash | 2.2× | ★★★★★ hip/knee complications 4.9% |
| Inova Loudoun Hospital (Leesburg) | Hospital | $212cash | 2.2× | ★★★★★ hip/knee complications 4.1% |
| Inova Mount Vernon Hospital (Alexandria) | Hospital | $212cash | 2.2× | ★★★★★ hip/knee complications 3.7% |
| Inova Fairfax Hospital (Falls Church) | Hospital | $212cash | 2.2× | ★★★★★ |
| Sentara Norfolk General Hospital (Norfolk) | Hospital | $216cash | 2.2× | ★★★★★ |
| Sentara CarePlex Hospital (Hampton) | Hospital | $216cash | 2.2× | ★★★★★ |
| Sentara Leigh Hospital — orthopedic-focused (Norfolk) | Hospital | $216cash | 2.2× | ★★★★★ hip/knee complications 6.2% |
| Sentara Obici Hospital (Suffolk) | Hospital | $216cash | 2.2× | ★★★★★ hip/knee complications 5.6% |
| Sentara Northern Virginia Medical Center (Woodbridge) | Hospital | $216cash | 2.2× | ★★★★★ |
| Sentara Virginia Beach General Hospital (Virginia Beach) | Hospital | $216cash | 2.2× | ★★★★★ hip/knee complications 3.7% |
| Sentara Princess Anne Hospital (Virginia Beach) | Hospital | $216cash | 2.2× | ★★★★★ |
| UVA Health University Medical Center (Charlottesville) | Hospital | $229cash | 2.3× | ★★★★★ hip/knee complications 4.3% |
| Wythe County Community Hospital (Wytheville) | Hospital | $251cash | 2.6× | ★★★★★ |
| Sentara Halifax Regional Hospital (South Boston) | Hospital | $252cash | 2.6× | ★★★★★ |
| Bon Secours Southside Medical Center (Petersburg) | Hospital | $256cash | 2.6× | ★★★★★ |
| Fauquier Hospital (Warrenton) | Hospital | $284cash | 2.9× | ★★★★★ hip/knee complications 5.6% |
| Sovah Health Martinsville (Martinsville) | Hospital | $294cash | 3.0× | — |
| Sovah Health Danville (Danville) | Hospital | $294cash | 3.0× | ★★★★★ hip/knee complications 4.4% |
| Bon Secours Maryview Medical Center (Portsmouth) | Hospital | $302cash | 3.1× | ★★★★★ |
| Bon Secours St. Mary's Hospital (Richmond) | Hospital | $304cash | 3.1× | ★★★★★ hip/knee complications 2.8% |
| Bon Secours St. Francis Medical Center (Midlothian) | Hospital | $304cash | 3.1× | ★★★★★ hip/knee complications 4.0% |
| Bon Secours Memorial Regional Medical Center (Mechanicsville) | Hospital | $304cash | 3.1× | ★★★★★ hip/knee complications 3.8% |
| Bon Secours Harbour View Medical Center (Suffolk) | Hospital | $305cash | 3.1× | — |
| Bon Secours Mary Immaculate Hospital (Newport News) | Hospital | $305cash | 3.1× | ★★★★★ hip/knee complications 4.7% |
| Clinch Valley Medical Center (Richlands) | Hospital | $439cash | 4.5× | ★★★★★ |
| LewisGale Hospital Montgomery (Blacksburg) | Hospital | $494cash | 5.0× | ★★★★★ hip/knee complications 3.9% |
| Spotsylvania Regional Medical Center (Fredericksburg) gross charge | Hospital | $690cash | 7.0× | ★★★★★ |
| LewisGale Hospital Pulaski (Pulaski) gross charge | Hospital | $753cash | 7.7× | ★★★★★ |
| LewisGale Medical Center (Salem) gross charge | Hospital | $763cash | 7.8× | ★★★★★ hip/knee complications 4.2% |
| StoneSprings Hospital Center (Dulles) gross charge | Hospital | $882cash | 9.0× | ★★★★★ hip/knee complications 3.1% |
| Reston Hospital Center (Reston) gross charge | Hospital | $882cash | 9.0× | ★★★★★ hip/knee complications 3.6% |
| TriCities Hospital, formerly John Randolph Medical Center (Hopewell) gross charge | Hospital | $914cash | 9.3× | ★★★★★ |
| Johnston-Willis Hospital, CJW Medical Center (Richmond) gross charge | Hospital | $914cash | 9.3× | ★★★★★ hip/knee complications 3.4% |
| Retreat Doctors' Hospital (Richmond) gross charge | Hospital | $914cash | 9.3× | ★★★★★ hip/knee complications 3.3% |
| Chippenham Hospital, CJW Medical Center (Richmond) gross charge | Hospital | $914cash | 9.3× | ★★★★★ hip/knee complications 3.4% |
| Henrico Doctors' Hospital, Forest campus (Richmond) gross charge | Hospital | $914cash | 9.3× | ★★★★★ hip/knee complications 3.3% |
| Parham Doctors' Hospital — ortho/spine-focused campus (Richmond) gross charge | Hospital | $914cash | 9.3× | ★★★★★ hip/knee complications 3.3% |
| LewisGale Hospital Alleghany (Low Moor) gross charge | Hospital | $1,164cash | 11.9× | ★★★★★ |
Prices from each hospital's public machine-readable file; imaging & surgery-center prices are published self-pay rates (often the cheapest option). vs Medicare is how many times the Medicare rate each facility charges. 12 unusually low/high prices excluded from the typical price as likely data errors.
See Physical therapy evaluation, low complexity prices in another area
What should 97161 cost in Virginia?
For Physical therapy evaluation, low complexity (CPT 97161) in Virginia, a fair self-pay price is around $212, with hospitals ranging from $158 to $305 across 60 facilities. Medicare's benchmark rate is $98, the floor to negotiate toward. The card above lists each hospital's price, cheapest first, with CMS quality stars.
Frequently asked questions
How much does Physical therapy evaluation, low complexity cost in Virginia?
A fair self-pay price for Physical therapy evaluation, low complexity (CPT 97161) in Virginia is around $212, with hospital prices ranging from $158 to $305 across 60 facilities. These are estimates from hospital-published prices, not a guarantee.
What is the Medicare rate for CPT 97161?
Medicare pays about $98 for Physical therapy evaluation, low complexity (CPT 97161). That's the negotiation floor — a fair cash-pay target is roughly 1.5–2× it, well below typical gross charges.
Can I negotiate the price of Physical therapy evaluation, low complexity?
Yes. Under the federal Hospital Price Transparency rule hospitals must publish these rates, so you can ask to pay the cash or negotiated rate instead of the gross charge. Paste your bill on the home page for a ready-to-send appeal letter and the exact numbers to cite.
Got a bill for this?
If you were charged more than the fair price, you can usually negotiate it down. Paste your itemized bill to get a personalized appeal letter, the exact numbers to cite, an AI negotiation coach, and a charity-care eligibility check — free.
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Prices last refreshed September 2026 from each hospital's official CMS machine-readable file. Medicare rate: CY2025 OPPS/PFS/CLFS. Estimates only — not a guarantee.