63030

Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc

Medicare pricing data for 7,500 providers across 52 states

🤖AI Overview

This procedure has a 7.7x markup — hospitals charge $5,922 but Medicare allows only $770.55. Uninsured patients may face bills 7.7 times higher than what insurance negotiates. Prices vary significantly by location — from $450 in South Dakota to $1,116 in Alaska. 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

Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc (HCPCS code 63030) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $770.55, but hospitals typically charge $5,922 — a 7.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$154.11

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $770.55, your out-of-pocket cost would be approximately $154.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$770.55
Average Hospital Charge
$5,922
Markup Ratio
7.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,922.38
Medicare Allowed$770.55
Medicare Payment$613.03

Hospitals charge 7.7x more than what Medicare allows for this procedure. Medicare actually pays $613.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,116$12,6412880+44.8%
Hawaii$1,053$8,0361022+36.7%
Washington$987$4,049220817+28.1%
Oregon$976$3,883129527+26.7%
Mississippi$969$8,07363289+25.8%
California$924$7,0675902,687+19.9%
Maryland$901$6,326154758+16.9%
Tennessee$885$3,811194753+14.8%
Connecticut$878$6,809105234+13.9%
Utah$869$4,462100362+12.8%
Michigan$868$5,804210497+12.7%
Georgia$863$6,939226641+12.0%
New Hampshire$841$6,65051205+9.2%
Ohio$840$4,736288829+9.0%
Arizona$837$6,044187834+8.6%
Illinois$811$9,4382541,000+5.2%
Florida$777$6,4495862,066+0.9%
North Dakota$766$3,77125105-0.6%
North Carolina$758$3,940277848-1.6%
Delaware$758$6,0252397-1.6%
Wyoming$751$5,1252141-2.5%
Louisiana$749$5,886120542-2.8%
New York$745$9,057336962-3.3%
Nebraska$745$4,38966331-3.4%
New Jersey$741$19,898196585-3.9%
Vermont$734$5,887612-4.8%
Rhode Island$706$5,8963261-8.4%
Colorado$705$4,393160585-8.5%
Minnesota$704$4,648150477-8.6%
Arkansas$701$3,16473260-9.0%
Texas$697$4,3245171,867-9.6%
Montana$694$3,59440128-10.0%
Missouri$693$6,266160511-10.1%
Pennsylvania$692$4,581289789-10.2%
Virginia$688$3,995174712-10.7%
Massachusetts$681$5,502163541-11.7%
Nevada$673$10,25072233-12.6%
South Carolina$672$3,990143607-12.8%
Indiana$670$5,589188649-13.1%
Kentucky$667$3,89889319-13.5%
District of Columbia$657$4,0811740-14.7%
Oklahoma$655$3,46193358-15.1%
West Virginia$637$2,4062760-17.4%
Iowa$630$4,32965260-18.2%
Wisconsin$586$9,839140315-23.9%
Puerto Rico$579$3,269516-24.9%
Maine$550$1,8473473-28.6%
New Mexico$495$2,8542489-35.8%
Alabama$484$3,054125564-37.2%
Idaho$482$5,83675321-37.5%
Kansas$461$2,71479347-40.1%
South Dakota$450$2,56247179-41.6%

⚠️ 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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