63053

Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back

Medicare pricing data for 4,348 providers across 49 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $910.77 but Medicare allows only $149.49. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Prices vary significantly by location — from $109 in Idaho to $234 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

Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back (HCPCS code 63053) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $149.49, but hospitals typically charge $910.77 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.90

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $149.49, your out-of-pocket cost would be approximately $29.90. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$149.49
Average Hospital Charge
$910.77
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$910.77
Medicare Allowed$149.49
Medicare Payment$119.33

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $119.33 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$234$5801398+56.3%
New York$179$1,676209748+19.9%
Illinois$169$820168942+13.1%
Pennsylvania$169$658145886+12.9%
California$164$8122261,017+9.6%
Florida$163$1,4163542,089+9.1%
Massachusetts$163$1,38797633+9.1%
Maryland$161$47290765+8.0%
Montana$161$50725268+7.9%
Virginia$158$6151301,009+5.8%
Michigan$158$742129650+5.6%
Maine$156$346738+4.5%
Iowa$156$62932125+4.2%
Georgia$154$1,136140582+3.3%
Kentucky$151$47755195+1.2%
Alaska$151$1,3421986+0.9%
Ohio$150$4801641,069+0.6%
Texas$150$7573081,859+0.4%
Tennessee$148$769107383-0.7%
Minnesota$147$83890408-1.8%
New Jersey$147$4,605113458-1.9%
Arkansas$146$89539134-2.1%
Utah$144$49251280-3.8%
Nebraska$143$45654305-4.6%
Mississippi$142$92030223-5.3%
South Carolina$141$54886410-5.4%
Connecticut$141$74757147-6.0%
Nevada$140$1,33048220-6.2%
Washington$140$614107683-6.2%
Arizona$140$6041381,458-6.7%
Colorado$138$527131929-7.8%
Kansas$137$49153266-8.5%
Oklahoma$136$47066483-8.7%
Louisiana$136$61890569-9.0%
Wyoming$135$6731270-9.9%
Oregon$135$70237129-10.0%
Rhode Island$134$1,04014101-10.5%
West Virginia$134$5461751-10.6%
North Carolina$133$682174772-10.8%
Missouri$131$808102481-12.5%
New Mexico$128$4991341-14.6%
Indiana$126$1,206126874-16.0%
Wisconsin$125$1,95669333-16.4%
New Hampshire$124$78726103-16.8%
Alabama$123$36864253-17.5%
North Dakota$123$36916206-17.6%
South Dakota$110$35725122-26.6%
Delaware$109$2,167745-27.0%
Idaho$109$2,35341193-27.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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