How much does physical therapy evaluation, moderate complexity cost in Virginia?
CPT 97162 — 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.
97162 Physical therapy evaluation, moderate complexity
Market typical price
$218
65 facilities · typical range $167 – $362 · 2.2× Medicare PFS
Typical
$218
Medicare $98
$75 lowboxed = typical rangehigh $1,306
What Medicare pays
$98
Market typical
$218
Cash / self-pay price
$262
Prices near you — 65 facilities, lowest first
| Facility | Type | Price | vs Medicare | Quality |
|---|---|---|---|---|
| Wythe County Community Hospital (Wytheville) lowest | Hospital | $75cash | 0.8× | ★★★★★ |
| Ballad Health Johnston Memorial Hospital (Abingdon) | Hospital | $78cash | 0.8× | ★★★★★ hip/knee complications 6.2% |
| Ballad Health Lonesome Pine Hospital (Big Stone Gap) | Hospital | $78cash | 0.8× | ★★★★★ |
| Ballad Health Russell County Hospital (Lebanon) | Hospital | $78cash | 0.8× | ★★★★★ |
| Ballad Health Smyth County Community Hospital (Marion) | Hospital | $78cash | 0.8× | ★★★★★ hip/knee complications 4.4% |
| Sentara Williamsburg Regional Medical Center (Williamsburg) | Hospital | $102negotiated | 1.0× | ★★★★★ hip/knee complications 5.6% |
| Bon Secours St. Francis Medical Center (Midlothian) | Hospital | $106cash | 1.1× | ★★★★★ hip/knee complications 4.0% |
| Bon Secours St. Mary's Hospital (Richmond) | Hospital | $106cash | 1.1× | ★★★★★ hip/knee complications 2.8% |
| Mary Washington Hospital (Fredericksburg) | Hospital | $125cash | 1.3× | ★★★★★ hip/knee complications 3.9% |
| Stafford Hospital (Stafford) | Hospital | $125cash | 1.3× | ★★★★★ |
| Riverside Doctors' Hospital of Williamsburg (Williamsburg) | Hospital | $130negotiated | 1.3× | ★★★★★ hip/knee complications 2.5% |
| Riverside Regional Medical Center (Newport News) | Hospital | $130negotiated | 1.3× | ★★★★★ |
| Riverside Walter Reed Hospital (Gloucester) | Hospital | $130negotiated | 1.3× | ★★★★★ hip/knee complications 2.9% |
| UVA Health Culpeper Medical Center (Culpeper) | Hospital | $150cash | 1.5× | ★★★★★ |
| Carilion New River Valley Medical Center (Christiansburg) | Hospital | $151cash | 1.5× | ★★★★★ |
| Carilion Roanoke Memorial Hospital (Roanoke) | Hospital | $151cash | 1.5× | ★★★★★ hip/knee complications 7.9% |
| Twin County Regional Hospital (Galax) | Hospital | $182cash | 1.9× | ★★★★★ |
| VCU Medical Center (Richmond) | Hospital | $184negotiated | 1.9× | ★★★★★ hip/knee complications 4.8% |
| Sentara Martha Jefferson Hospital (Charlottesville) | Hospital | $208cash | 2.1× | ★★★★★ hip/knee complications 4.9% |
| Sentara RMH Medical Center (Harrisonburg) | Hospital | $208cash | 2.1× | ★★★★★ hip/knee complications 3.9% |
| 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 Fairfax Hospital (Falls Church) | Hospital | $212cash | 2.2× | ★★★★★ |
| 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% |
| UVA Health Haymarket Medical Center (Haymarket) | Hospital | $218cash | 2.2× | ★★★★★ |
| UVA Health Prince William Medical Center (Manassas) | Hospital | $218cash | 2.2× | ★★★★★ |
| Augusta Health (Fishersville) | Hospital | $228cash | 2.3× | ★★★★★ hip/knee complications 4.3% |
| Chesapeake Regional Medical Center (Chesapeake) | Hospital | $229cash | 2.3× | ★★★★★ hip/knee complications 4.6% |
| Bon Secours Harbour View Medical Center (Suffolk) | Hospital | $244cash | 2.5× | — |
| Bon Secours Mary Immaculate Hospital (Newport News) | Hospital | $244cash | 2.5× | ★★★★★ hip/knee complications 4.7% |
| Centra Lynchburg General Hospital (Lynchburg) | Hospital | $246cash | 2.5× | ★★★★★ hip/knee complications 3.3% |
| Centra Virginia Baptist Hospital (Lynchburg) | Hospital | $246cash | 2.5× | ★★★★★ hip/knee complications 3.3% |
| Bon Secours Southside Medical Center (Petersburg) | Hospital | $256cash | 2.6× | ★★★★★ |
| UVA Health University Medical Center (Charlottesville) | Hospital | $261cash | 2.7× | ★★★★★ hip/knee complications 4.3% |
| Sentara CarePlex Hospital (Hampton) | Hospital | $264cash | 2.7× | ★★★★★ |
| Sentara Leigh Hospital — orthopedic-focused (Norfolk) | Hospital | $264cash | 2.7× | ★★★★★ hip/knee complications 6.2% |
| Sentara Norfolk General Hospital (Norfolk) | Hospital | $264cash | 2.7× | ★★★★★ |
| Sentara Northern Virginia Medical Center (Woodbridge) | Hospital | $264cash | 2.7× | ★★★★★ |
| Sentara Obici Hospital (Suffolk) | Hospital | $264cash | 2.7× | ★★★★★ hip/knee complications 5.6% |
| Sentara Princess Anne Hospital (Virginia Beach) | Hospital | $264cash | 2.7× | ★★★★★ |
| Sentara Virginia Beach General Hospital (Virginia Beach) | Hospital | $264cash | 2.7× | ★★★★★ hip/knee complications 3.7% |
| Sentara Halifax Regional Hospital (South Boston) | Hospital | $269cash | 2.7× | ★★★★★ |
| Sovah Health Danville (Danville) | Hospital | $294cash | 3.0× | ★★★★★ hip/knee complications 4.4% |
| Sovah Health Martinsville (Martinsville) | Hospital | $294cash | 3.0× | — |
| Bon Secours Maryview Medical Center (Portsmouth) | Hospital | $302cash | 3.1× | ★★★★★ |
| Fauquier Hospital (Warrenton) | Hospital | $304cash | 3.1× | ★★★★★ hip/knee complications 5.6% |
| Valley Health Warren Memorial Hospital (Front Royal) | Hospital | $358cash | 3.6× | ★★★★★ hip/knee complications 3.8% |
| Valley Health Winchester Medical Center (Winchester) | Hospital | $358cash | 3.6× | ★★★★★ hip/knee complications 2.6% |
| Bon Secours Memorial Regional Medical Center (Mechanicsville) | Hospital | $366cash | 3.7× | ★★★★★ hip/knee complications 3.8% |
| VHC Health, Virginia Hospital Center (Arlington) | Hospital | $370cash | 3.8× | ★★★★★ hip/knee complications 4.4% |
| Clinch Valley Medical Center (Richlands) | Hospital | $483cash | 4.9× | ★★★★★ |
| LewisGale Hospital Montgomery (Blacksburg) | Hospital | $644cash | 6.6× | ★★★★★ hip/knee complications 3.9% |
| Spotsylvania Regional Medical Center (Fredericksburg) gross charge | Hospital | $711cash | 7.3× | ★★★★★ |
| LewisGale Hospital Pulaski (Pulaski) gross charge | Hospital | $753cash | 7.7× | ★★★★★ |
| Reston Hospital Center (Reston) gross charge | Hospital | $882cash | 9.0× | ★★★★★ hip/knee complications 3.6% |
| StoneSprings Hospital Center (Dulles) gross charge | Hospital | $882cash | 9.0× | ★★★★★ hip/knee complications 3.1% |
| Chippenham Hospital, CJW Medical Center (Richmond) gross charge | Hospital | $997cash | 10.2× | ★★★★★ hip/knee complications 3.4% |
| Henrico Doctors' Hospital, Forest campus (Richmond) gross charge | Hospital | $997cash | 10.2× | ★★★★★ hip/knee complications 3.3% |
| Johnston-Willis Hospital, CJW Medical Center (Richmond) gross charge | Hospital | $997cash | 10.2× | ★★★★★ hip/knee complications 3.4% |
| Parham Doctors' Hospital — ortho/spine-focused campus (Richmond) gross charge | Hospital | $997cash | 10.2× | ★★★★★ hip/knee complications 3.3% |
| Retreat Doctors' Hospital (Richmond) gross charge | Hospital | $997cash | 10.2× | ★★★★★ hip/knee complications 3.3% |
| TriCities Hospital, formerly John Randolph Medical Center (Hopewell) gross charge | Hospital | $997cash | 10.2× | ★★★★★ |
| LewisGale Medical Center (Salem) gross charge | Hospital | $1,019cash | 10.4× | ★★★★★ hip/knee complications 4.2% |
| LewisGale Hospital Alleghany (Low Moor) gross charge | Hospital | $1,306cash | 13.3× | ★★★★★ |
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, moderate complexity prices in another area
What should 97162 cost in Virginia?
For physical therapy evaluation, moderate complexity (CPT 97162) in Virginia, a fair self-pay price is around $218, with hospitals ranging from $167 to $362 across 65 facilities. Medicare's benchmark rate is $98, the benchmark every published rate is measured against. The card above lists each hospital's price, cheapest first, with CMS quality stars.
Frequently asked questions
How much does physical therapy evaluation, moderate complexity cost in Virginia?
A fair self-pay price for physical therapy evaluation, moderate complexity (CPT 97162) in Virginia is around $218, with hospital prices ranging from $167 to $362 across 65 facilities. These are estimates from hospital-published prices, not a guarantee.
What is the Medicare rate for CPT 97162?
Medicare pays about $98 for physical therapy evaluation, moderate complexity (CPT 97162). 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, moderate 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.
Placing a referral for this?
Enter the patient's ZIP and plan in the facility finder to see every facility near them that publishes a price for 97162, ranked, with the phone number and an out-of-pocket estimate.
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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.