62328

Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance

Medicare pricing data for 8,693 providers across 51 states

🤖AI Overview

This procedure has a 6.7x markup — hospitals charge $592.63 but Medicare allows only $87.87. Uninsured patients may face bills 6.7 times higher than what insurance negotiates. 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 spinal fluid with lower back spinal tap for diagnostic test using imaging guidance (HCPCS code 62328) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $87.87, but hospitals typically charge $592.63 — a 6.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$17.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $87.87, your out-of-pocket cost would be approximately $17.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$87.87
Average Hospital Charge
$592.63
Markup Ratio
6.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$592.63
Medicare Allowed$87.87
Medicare Payment$68.78

Hospitals charge 6.7x more than what Medicare allows for this procedure. Medicare actually pays $68.78 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nevada$124$800133404+40.6%
Alaska$102$60322103+16.3%
California$101$6018013,946+15.1%
Maryland$99$450145918+12.4%
Tennessee$95$5962411,025+8.5%
New York$95$9743401,907+7.9%
District of Columbia$92$42524141+4.4%
Florida$91$7955702,940+3.8%
Arizona$90$910163874+2.7%
Massachusetts$90$492189773+2.5%
Connecticut$90$676107478+2.0%
Washington$89$397204956+0.8%
Illinois$88$6223671,554+0.6%
North Carolina$88$5683431,533+0.3%
New Hampshire$88$75857248+0.2%
Michigan$88$4212381,082+0.1%
Texas$88$6906773,480-0.0%
New Jersey$88$446158764-0.4%
Vermont$85$1,043843-3.2%
Wyoming$85$49220103-3.3%
Delaware$85$30524108-3.5%
Virginia$85$4202221,061-3.7%
Oregon$84$392139526-4.1%
Hawaii$84$5152453-4.3%
Pennsylvania$84$4563681,689-4.5%
Montana$83$34840121-5.1%
Rhode Island$83$35832134-5.5%
Missouri$83$4141991,031-6.0%
Minnesota$82$605220933-6.6%
Colorado$82$477178638-6.7%
New Mexico$82$47539120-6.9%
North Dakota$82$65327148-6.9%
South Dakota$81$33225221-7.3%
Kansas$81$239112842-7.5%
Maine$81$32634121-7.8%
Wisconsin$81$1,439272726-7.9%
Alabama$81$319158598-7.9%
Louisiana$81$571136644-8.2%
Arkansas$81$374113522-8.3%
Iowa$80$53891362-8.6%
Georgia$80$623245944-9.1%
Indiana$80$501186758-9.4%
Ohio$79$5672941,410-9.9%
West Virginia$79$36846184-10.4%
Nebraska$78$50438322-10.8%
Mississippi$77$51786626-12.0%
South Carolina$77$485149812-12.7%
Kentucky$77$465114664-12.9%
Oklahoma$76$53191494-13.0%
Utah$73$31265331-17.4%
Idaho$72$51749250-17.9%

⚠️ 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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