64633

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

Medicare pricing data for 8,940 providers across 52 states

🤖AI Overview

This procedure has a 6.2x markup — hospitals charge $2,849 but Medicare allows only $460.92. Uninsured patients may face bills 6.2 times higher than what insurance negotiates. Prices vary significantly by location — from $247 in West Virginia to $579 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 upper or middle spinal facet joint nerves using imaging guidance, single facet joint (HCPCS code 64633) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $460.92, but hospitals typically charge $2,849 — a 6.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$92.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $460.92, your out-of-pocket cost would be approximately $92.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$460.92
Average Hospital Charge
$2,849
Markup Ratio
6.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,849.25
Medicare Allowed$460.92
Medicare Payment$363.20

Hospitals charge 6.2x more than what Medicare allows for this procedure. Medicare actually pays $363.20 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$579$4,44524147+25.6%
California$552$4,2207868,480+19.8%
Connecticut$543$2,71573485+17.9%
Hawaii$540$1,5121341+17.2%
New Jersey$531$6,1693172,177+15.2%
Nevada$527$4,5881131,573+14.3%
Oregon$525$2,2861091,507+13.8%
Maryland$506$2,9052332,807+9.7%
New York$506$2,5914243,129+9.7%
Delaware$498$2,56543470+8.1%
Colorado$496$2,9791812,307+7.7%
Wyoming$493$3,07013114+7.0%
Washington$480$1,8741531,764+4.2%
Georgia$480$3,1283675,740+4.1%
Florida$475$3,33591112,725+3.1%
Arizona$469$2,4712845,676+1.8%
Minnesota$465$2,5861581,903+0.9%
Texas$462$3,39186410,190+0.2%
Kentucky$457$2,1611101,571-0.8%
Indiana$445$3,2272052,010-3.5%
Pennsylvania$441$1,9103522,559-4.3%
Tennessee$439$2,3311852,886-4.7%
Virginia$438$1,7661511,788-4.9%
Arkansas$437$1,7451251,988-5.1%
Nebraska$433$2,32257633-6.0%
Oklahoma$433$1,5911031,704-6.2%
Michigan$427$2,0022602,007-7.4%
District of Columbia$426$1,5711059-7.5%
New Mexico$421$2,04355662-8.7%
Rhode Island$420$2,29913100-8.8%
Alabama$420$1,48294840-8.9%
New Hampshire$419$2,12550411-9.0%
Illinois$418$2,6442942,383-9.4%
Mississippi$417$2,359761,449-9.5%
South Carolina$417$1,9191241,568-9.5%
Iowa$414$2,20968629-10.3%
North Carolina$413$1,8172421,990-10.3%
Kansas$407$2,369851,050-11.6%
Louisiana$405$2,9091612,799-12.1%
Montana$402$1,46929261-12.8%
Massachusetts$402$1,8131611,168-12.9%
Idaho$398$1,65149592-13.6%
Utah$392$1,5191151,358-14.9%
Wisconsin$391$3,6661601,457-15.1%
North Dakota$371$1,89818156-19.5%
Puerto Rico$369$4261061-19.9%
Ohio$359$1,5093082,744-22.0%
Missouri$353$2,1531181,427-23.3%
Maine$302$1,23823121-34.5%
Vermont$286$2,16513141-37.9%
South Dakota$275$87020228-40.3%
West Virginia$247$83128296-46.4%

⚠️ 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