Fusion of lower spine bone through abdomen with partial removal of disc
Medicare pricing data for 5,578 providers across 52 states
This procedure has a 8.9x markup — hospitals charge $6,194 but Medicare allows only $698.61. Uninsured patients may face bills 8.9 times higher than what insurance negotiates. Prices vary significantly by location — from $449 in Delaware to $944 in District of Columbia. 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
Fusion of lower spine bone through abdomen with partial removal of disc (HCPCS code 22558) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $698.61, but hospitals typically charge $6,194 — a 8.9x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $698.61, your out-of-pocket cost would be approximately $139.72. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 8.9x more than what Medicare allows for this procedure. Medicare actually pays $556.93 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $944 | $3,020 | 13 | 94 | +35.1% |
| West Virginia | $931 | $3,965 | 15 | 67 | +33.2% |
| Alaska | $903 | $11,459 | 22 | 121 | +29.2% |
| Michigan | $887 | $6,687 | 138 | 526 | +27.0% |
| New York | $885 | $10,361 | 216 | 1,075 | +26.7% |
| Rhode Island | $826 | $8,074 | 35 | 136 | +18.2% |
| Puerto Rico | $816 | $3,189 | 7 | 56 | +16.7% |
| Vermont | $806 | $7,241 | 6 | 15 | +15.4% |
| Pennsylvania | $803 | $5,322 | 174 | 889 | +15.0% |
| Virginia | $803 | $4,277 | 148 | 1,227 | +14.9% |
| Massachusetts | $798 | $7,272 | 94 | 388 | +14.2% |
| Illinois | $788 | $9,296 | 175 | 857 | +12.8% |
| New Jersey | $785 | $14,259 | 148 | 593 | +12.3% |
| Maine | $772 | $4,495 | 8 | 15 | +10.5% |
| Montana | $765 | $5,517 | 32 | 250 | +9.5% |
| Kentucky | $760 | $4,406 | 64 | 529 | +8.7% |
| Florida | $750 | $6,546 | 447 | 3,220 | +7.4% |
| Connecticut | $740 | $7,839 | 97 | 367 | +6.0% |
| New Mexico | $738 | $14,452 | 16 | 118 | +5.6% |
| California | $732 | $7,746 | 552 | 4,582 | +4.7% |
| Iowa | $729 | $4,714 | 54 | 245 | +4.4% |
| Ohio | $723 | $5,209 | 186 | 1,349 | +3.4% |
| Maryland | $717 | $3,961 | 106 | 691 | +2.6% |
| New Hampshire | $710 | $6,245 | 23 | 90 | +1.6% |
| South Dakota | $709 | $3,942 | 28 | 183 | +1.5% |
| Wyoming | $706 | $6,590 | 12 | 68 | +1.1% |
| Wisconsin | $684 | $13,244 | 72 | 302 | -2.1% |
| Arizona | $670 | $5,025 | 150 | 1,393 | -4.1% |
| Missouri | $669 | $4,888 | 133 | 947 | -4.2% |
| Tennessee | $668 | $4,506 | 125 | 904 | -4.4% |
| Oregon | $665 | $3,919 | 93 | 527 | -4.8% |
| Georgia | $662 | $5,725 | 206 | 1,329 | -5.2% |
| Texas | $660 | $7,588 | 436 | 3,686 | -5.5% |
| Kansas | $659 | $3,776 | 58 | 550 | -5.7% |
| North Carolina | $654 | $4,079 | 197 | 1,691 | -6.4% |
| Louisiana | $642 | $7,019 | 119 | 1,053 | -8.1% |
| Oklahoma | $641 | $3,092 | 75 | 785 | -8.2% |
| Minnesota | $640 | $5,961 | 114 | 634 | -8.4% |
| Alabama | $632 | $3,986 | 111 | 1,193 | -9.6% |
| Mississippi | $631 | $5,823 | 26 | 131 | -9.7% |
| Colorado | $631 | $5,826 | 143 | 1,156 | -9.7% |
| North Dakota | $629 | $4,678 | 11 | 28 | -9.9% |
| Nebraska | $626 | $6,178 | 43 | 209 | -10.4% |
| South Carolina | $618 | $4,284 | 95 | 956 | -11.6% |
| Washington | $615 | $3,391 | 169 | 1,105 | -11.9% |
| Indiana | $614 | $5,696 | 114 | 717 | -12.2% |
| Nevada | $594 | $11,217 | 65 | 429 | -15.0% |
| Hawaii | $572 | $3,230 | 10 | 47 | -18.2% |
| Idaho | $570 | $4,452 | 60 | 442 | -18.4% |
| Utah | $546 | $3,359 | 66 | 537 | -21.8% |
| Arkansas | $530 | $3,394 | 32 | 131 | -24.2% |
| Delaware | $449 | $5,369 | 29 | 206 | -35.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber