0275T

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin

Medicare pricing data for 2,025 providers across 45 states

🤖AI Overview

Prices vary significantly by location — from $528 in Maine to $3,141 in New Jersey. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin (HCPCS code 0275T) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2,537, but hospitals typically charge $10,901 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$507.44

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2,537, your out-of-pocket cost would be approximately $507.44. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2,537
Average Hospital Charge
$10,901
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$10,900.79
Medicare Allowed$2,537.22
Medicare Payment$2,019.19

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $2,019 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$3,141$12,6231241,611+23.8%
Maryland$3,007$12,990911,437+18.5%
California$2,922$14,0811681,677+15.2%
Washington$2,908$9,32918217+14.6%
Oregon$2,838$8,14331164+11.8%
Florida$2,824$14,0772793,424+11.3%
Indiana$2,792$13,03950507+10.1%
Colorado$2,756$17,95622154+8.6%
Connecticut$2,753$9,70016123+8.5%
Nebraska$2,712$9,91930479+6.9%
Pennsylvania$2,682$7,3911032,623+5.7%
Arizona$2,677$11,91074742+5.5%
Georgia$2,586$18,27272613+1.9%
Arkansas$2,479$4,56916215-2.3%
Texas$2,420$17,1421561,687-4.6%
Minnesota$2,419$7,08329144-4.7%
Nevada$2,413$13,2911269-4.9%
Tennessee$2,403$6,01726379-5.3%
Michigan$2,343$8,74344300-7.6%
New Hampshire$2,332$7,688870-8.1%
New York$2,331$8,3421141,143-8.1%
Massachusetts$2,241$6,02727273-11.7%
South Dakota$2,219$4,042655-12.5%
Delaware$2,109$5,862523-16.9%
Iowa$2,107$5,56913138-17.0%
Utah$2,086$15,808630-17.8%
Missouri$2,037$6,67442678-19.7%
Kansas$2,034$6,13126330-19.8%
Louisiana$1,925$11,14519181-24.1%
Ohio$1,885$4,90468478-25.7%
Illinois$1,858$8,22073523-26.8%
South Carolina$1,836$7,05025300-27.6%
Virginia$1,807$6,71623201-28.8%
North Carolina$1,793$6,56352447-29.3%
Mississippi$1,782$5,20315230-29.8%
Oklahoma$1,648$4,43411163-35.0%
Alabama$1,636$4,60015167-35.5%
Wisconsin$1,555$10,28439258-38.7%
North Dakota$1,483$3,419782-41.6%
West Virginia$1,297$4,01310114-48.9%
Idaho$1,195$4,69611108-52.9%
Kentucky$1,157$4,60723117-54.4%
District of Columbia$1,056$5,578325-58.4%
New Mexico$737$7,877443-71.0%
Maine$528$3,262112-79.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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