63047

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment

Medicare pricing data for 11,451 providers across 52 states

🤖AI Overview

This procedure has a 8.1x markup — hospitals charge $5,524 but Medicare allows only $678.14. Uninsured patients may face bills 8.1 times higher than what insurance negotiates. Prices vary significantly by location — from $444 in South Dakota to $1,035 in Hawaii. 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 and/or nerves, 1 segment (HCPCS code 63047) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $678.14, but hospitals typically charge $5,524 — a 8.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$135.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $678.14, your out-of-pocket cost would be approximately $135.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$678.14
Average Hospital Charge
$5,524
Markup Ratio
8.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,523.51
Medicare Allowed$678.14
Medicare Payment$539.76

Hospitals charge 8.1x more than what Medicare allows for this procedure. Medicare actually pays $539.76 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$1,035$3,72525226+52.7%
Oregon$991$4,2511742,335+46.1%
Mississippi$859$7,512791,069+26.7%
New Hampshire$833$6,76868623+22.8%
Maryland$778$4,4962543,432+14.7%
Washington$774$3,4013123,971+14.1%
Montana$771$3,71357653+13.6%
Alaska$767$10,60350588+13.1%
Arizona$760$5,3252913,633+12.1%
Illinois$750$8,5223674,274+10.6%
Arkansas$745$3,787881,433+9.9%
Florida$744$6,46587910,459+9.7%
District of Columbia$740$3,27134335+9.2%
California$730$6,59693410,287+7.6%
North Dakota$728$3,17230475+7.3%
New York$727$9,7446185,137+7.3%
Vermont$726$4,98813128+7.0%
Missouri$708$4,7112412,622+4.4%
Massachusetts$699$5,0052382,821+3.1%
North Carolina$686$3,6283934,591+1.2%
Georgia$682$5,5153673,699+0.5%
Maine$679$2,27446289+0.1%
Michigan$678$5,1043453,002-0.1%
Connecticut$676$6,7682011,315-0.3%
New Jersey$664$15,7273323,008-2.0%
Ohio$663$3,8034345,280-2.2%
South Carolina$662$4,0721822,746-2.3%
Colorado$658$4,8812722,965-3.0%
Kentucky$657$3,6781321,309-3.2%
West Virginia$654$3,07650328-3.5%
Texas$650$4,33683210,851-4.1%
Minnesota$641$4,9212082,215-5.5%
Utah$633$3,4121281,588-6.6%
Rhode Island$632$6,31254385-6.8%
Pennsylvania$623$5,3184735,153-8.2%
Louisiana$622$5,3491891,789-8.3%
Tennessee$614$3,4682593,323-9.5%
Indiana$614$5,6982433,284-9.5%
Wyoming$612$5,72331336-9.7%
New Mexico$606$3,94442312-10.6%
Virginia$593$3,6842623,410-12.5%
Wisconsin$587$11,2081961,801-13.4%
Nebraska$563$3,670971,243-17.0%
Nevada$563$9,4411171,409-17.0%
Oklahoma$531$2,6061362,163-21.7%
Idaho$528$6,665951,097-22.1%
Alabama$503$3,3561882,188-25.9%
Iowa$496$3,580971,720-26.9%
Kansas$492$3,2101172,440-27.5%
Delaware$463$5,26248851-31.7%
Puerto Rico$454$3,2621231-33.0%
South Dakota$444$2,91766757-34.5%

⚠️ 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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