64625

Destruction of nerves supplying joint between spine and pelvis using imaging guidance

Medicare pricing data for 2,996 providers across 40 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $2,638 but Medicare allows only $457.59. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. Prices vary significantly by location — from $190 in West Virginia to $647 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

Destruction of nerves supplying joint between spine and pelvis using imaging guidance (HCPCS code 64625) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $457.59, but hospitals typically charge $2,638 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$91.52

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $457.59, your out-of-pocket cost would be approximately $91.52. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$457.59
Average Hospital Charge
$2,638
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,637.51
Medicare Allowed$457.59
Medicare Payment$356.73

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $356.73 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$647$3,196411+41.3%
New Jersey$551$8,64991338+20.4%
Delaware$526$2,4741161+14.9%
Arkansas$520$1,45163675+13.6%
California$504$2,8622901,367+10.2%
Illinois$503$7,277322+9.8%
Oregon$500$1,88241161+9.4%
Maryland$499$2,377117871+9.0%
Washington$491$3,06463371+7.4%
Colorado$484$3,06284507+5.8%
Arizona$484$2,323115597+5.7%
Florida$476$2,9534403,853+3.9%
Nevada$475$4,05035157+3.8%
Virginia$474$1,60961277+3.7%
Georgia$466$2,715139451+1.7%
Tennessee$460$2,34057189+0.5%
South Carolina$453$2,91157272-1.0%
Texas$451$2,7784203,509-1.3%
Nebraska$445$2,5281662-2.7%
New Mexico$441$1,85928246-3.6%
Kentucky$427$1,6322569-6.6%
Montana$421$1,637935-7.9%
Pennsylvania$418$2,136132591-8.7%
Utah$416$1,68633110-9.0%
Oklahoma$415$1,17567569-9.3%
Louisiana$411$3,36166634-10.1%
Mississippi$405$2,14951496-11.6%
Michigan$390$2,14657135-14.8%
Indiana$373$2,6823679-18.6%
Missouri$370$1,8082558-19.2%
North Carolina$361$1,34288375-21.1%
Alabama$354$1,4072465-22.5%
Wyoming$350$1,662616-23.5%
Ohio$347$1,267110496-24.1%
Kansas$339$3,883919-26.0%
North Dakota$338$1,765726-26.1%
Idaho$317$9402680-30.7%
South Dakota$266$460932-41.8%
New York$215$940833-53.0%
West Virginia$190$697936-58.4%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber