Fusion of spine in lower back
Medicare pricing data for 9,225 providers across 52 states
Prices vary significantly by location — from $785 in South Dakota to $2,529 in Mississippi. 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 lower back (HCPCS code 22612) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,454, but hospitals typically charge $7,053 — a 4.9x 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 $1,454, your out-of-pocket cost would be approximately $290.86. 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 4.9x more than what Medicare allows for this procedure. Medicare actually pays $1,159 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Mississippi | $2,529 | $9,254 | 64 | 478 | +73.9% |
| North Dakota | $2,378 | $6,596 | 22 | 68 | +63.5% |
| New Jersey | $2,363 | $19,928 | 263 | 1,479 | +62.5% |
| Kansas | $2,026 | $6,914 | 112 | 1,477 | +39.3% |
| Maryland | $2,004 | $7,687 | 235 | 2,129 | +37.8% |
| Nebraska | $1,863 | $6,946 | 84 | 561 | +28.1% |
| Arkansas | $1,802 | $5,284 | 88 | 433 | +23.9% |
| Nevada | $1,772 | $12,257 | 106 | 677 | +21.8% |
| California | $1,728 | $8,007 | 766 | 6,904 | +18.8% |
| Wisconsin | $1,706 | $14,623 | 151 | 831 | +17.3% |
| Illinois | $1,678 | $11,226 | 304 | 1,707 | +15.4% |
| Oregon | $1,657 | $5,253 | 119 | 651 | +13.9% |
| Arizona | $1,645 | $6,231 | 237 | 1,905 | +13.1% |
| Florida | $1,639 | $8,179 | 719 | 5,054 | +12.7% |
| Texas | $1,638 | $6,978 | 754 | 6,551 | +12.6% |
| Michigan | $1,501 | $6,661 | 279 | 1,602 | +3.2% |
| Idaho | $1,457 | $7,992 | 87 | 655 | +0.2% |
| Pennsylvania | $1,452 | $6,637 | 370 | 2,697 | -0.1% |
| Massachusetts | $1,422 | $7,257 | 180 | 1,240 | -2.2% |
| Utah | $1,408 | $4,654 | 115 | 948 | -3.2% |
| New York | $1,402 | $9,759 | 459 | 2,298 | -3.6% |
| District of Columbia | $1,397 | $4,283 | 28 | 229 | -3.9% |
| Vermont | $1,343 | $7,709 | 9 | 62 | -7.7% |
| Minnesota | $1,338 | $6,902 | 166 | 1,095 | -8.0% |
| New Mexico | $1,310 | $5,061 | 19 | 114 | -9.9% |
| New Hampshire | $1,291 | $8,460 | 45 | 200 | -11.2% |
| Georgia | $1,285 | $6,523 | 297 | 2,231 | -11.6% |
| Rhode Island | $1,261 | $10,128 | 46 | 282 | -13.3% |
| Ohio | $1,248 | $4,782 | 348 | 2,993 | -14.2% |
| West Virginia | $1,237 | $4,515 | 34 | 197 | -15.0% |
| Virginia | $1,179 | $5,238 | 221 | 1,915 | -19.0% |
| Alabama | $1,176 | $5,251 | 157 | 1,512 | -19.1% |
| Alaska | $1,176 | $11,833 | 31 | 165 | -19.1% |
| South Carolina | $1,168 | $4,645 | 158 | 1,445 | -19.7% |
| Connecticut | $1,157 | $7,529 | 150 | 786 | -20.5% |
| Colorado | $1,150 | $6,005 | 200 | 1,408 | -20.9% |
| Indiana | $1,150 | $6,389 | 198 | 1,463 | -20.9% |
| Puerto Rico | $1,133 | $3,530 | 12 | 59 | -22.1% |
| Wyoming | $1,122 | $7,100 | 20 | 135 | -22.8% |
| Louisiana | $1,097 | $8,208 | 158 | 1,209 | -24.5% |
| Missouri | $1,090 | $5,243 | 186 | 1,253 | -25.0% |
| Tennessee | $1,061 | $4,287 | 197 | 1,992 | -27.1% |
| Hawaii | $1,053 | $3,179 | 14 | 123 | -27.6% |
| Washington | $1,036 | $3,849 | 213 | 1,417 | -28.8% |
| North Carolina | $1,033 | $4,022 | 304 | 2,330 | -29.0% |
| Kentucky | $1,030 | $4,173 | 104 | 706 | -29.2% |
| Oklahoma | $1,025 | $3,565 | 130 | 1,641 | -29.5% |
| Maine | $970 | $4,193 | 19 | 37 | -33.3% |
| Delaware | $961 | $7,153 | 41 | 873 | -33.9% |
| Montana | $911 | $5,459 | 41 | 207 | -37.3% |
| Iowa | $860 | $4,747 | 72 | 933 | -40.9% |
| South Dakota | $785 | $3,522 | 50 | 319 | -46.0% |
⚠️ 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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