Fusion of spine in upper back
Medicare pricing data for 4,896 providers across 50 states
This procedure has a 7.7x markup — hospitals charge $4,909 but Medicare allows only $634.52. Uninsured patients may face bills 7.7 times higher than what insurance negotiates. Prices vary significantly by location — from $399 in Idaho to $844 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 spine in upper back (HCPCS code 22610) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $634.52, but hospitals typically charge $4,909 — a 7.7x 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 $634.52, your out-of-pocket cost would be approximately $126.90. 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 7.7x more than what Medicare allows for this procedure. Medicare actually pays $506.12 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $844 | $4,140 | 21 | 69 | +33.0% |
| Maryland | $785 | $4,802 | 105 | 375 | +23.8% |
| Rhode Island | $743 | $6,760 | 19 | 56 | +17.1% |
| New York | $728 | $8,889 | 250 | 608 | +14.8% |
| Michigan | $728 | $5,227 | 173 | 459 | +14.7% |
| West Virginia | $724 | $3,306 | 22 | 62 | +14.2% |
| Pennsylvania | $724 | $3,873 | 191 | 435 | +14.1% |
| Illinois | $721 | $7,257 | 162 | 365 | +13.7% |
| Wyoming | $717 | $4,368 | 9 | 22 | +13.0% |
| Virginia | $707 | $3,979 | 133 | 321 | +11.5% |
| New Jersey | $704 | $12,536 | 109 | 212 | +11.0% |
| Massachusetts | $702 | $5,821 | 103 | 256 | +10.6% |
| Mississippi | $690 | $3,389 | 38 | 71 | +8.7% |
| Maine | $673 | $2,351 | 11 | 25 | +6.0% |
| Kentucky | $670 | $3,002 | 68 | 180 | +5.6% |
| New Mexico | $667 | $4,354 | 16 | 30 | +5.1% |
| Connecticut | $666 | $5,900 | 75 | 125 | +4.9% |
| Florida | $663 | $5,151 | 350 | 855 | +4.4% |
| Alaska | $660 | $9,444 | 25 | 39 | +4.1% |
| Montana | $659 | $2,841 | 20 | 35 | +3.9% |
| Hawaii | $652 | $2,481 | 12 | 34 | +2.8% |
| Ohio | $645 | $3,914 | 217 | 629 | +1.7% |
| Washington | $641 | $2,990 | 116 | 266 | +1.0% |
| Louisiana | $640 | $4,756 | 88 | 192 | +0.9% |
| Georgia | $640 | $4,294 | 141 | 315 | +0.8% |
| Utah | $628 | $3,549 | 47 | 71 | -1.0% |
| Nebraska | $614 | $3,733 | 42 | 78 | -3.2% |
| Minnesota | $610 | $4,988 | 99 | 217 | -3.9% |
| California | $609 | $5,464 | 421 | 1,365 | -4.0% |
| Arizona | $606 | $4,294 | 140 | 394 | -4.6% |
| Oregon | $598 | $3,716 | 52 | 119 | -5.7% |
| Kansas | $597 | $3,512 | 54 | 130 | -5.9% |
| Missouri | $593 | $4,119 | 117 | 329 | -6.5% |
| North Dakota | $593 | $2,828 | 13 | 23 | -6.6% |
| Texas | $592 | $4,335 | 360 | 903 | -6.6% |
| Tennessee | $581 | $3,665 | 115 | 338 | -8.5% |
| Wisconsin | $580 | $12,756 | 66 | 123 | -8.5% |
| Iowa | $578 | $4,083 | 40 | 99 | -8.9% |
| Indiana | $575 | $4,221 | 100 | 201 | -9.3% |
| North Carolina | $573 | $3,435 | 191 | 469 | -9.7% |
| South Carolina | $572 | $3,736 | 74 | 165 | -9.8% |
| Alabama | $557 | $3,004 | 76 | 232 | -12.2% |
| Arkansas | $544 | $2,868 | 38 | 107 | -14.2% |
| Oklahoma | $538 | $2,396 | 82 | 283 | -15.3% |
| South Dakota | $525 | $3,152 | 27 | 60 | -17.2% |
| Colorado | $517 | $3,647 | 133 | 381 | -18.5% |
| Nevada | $500 | $7,223 | 45 | 97 | -21.2% |
| New Hampshire | $474 | $9,593 | 18 | 35 | -25.2% |
| Delaware | $457 | $5,098 | 26 | 82 | -28.0% |
| Idaho | $399 | $5,310 | 40 | 121 | -37.1% |
⚠️ 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