Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint
Medicare pricing data for 11,844 providers across 52 states
This procedure has a 6.2x markup — hospitals charge $2,938 but Medicare allows only $476.17. Uninsured patients may face bills 6.2 times higher than what insurance negotiates. Prices vary significantly by location — from $254 in West Virginia to $625 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 lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS code 64635) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $476.17, but hospitals typically charge $2,938 — a 6.2x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $476.17, your out-of-pocket cost would be approximately $95.23. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.2x more than what Medicare allows for this procedure. Medicare actually pays $375.31 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $625 | $6,197 | 30 | 410 | +31.2% |
| California | $571 | $3,984 | 1,091 | 30,211 | +20.0% |
| Connecticut | $562 | $3,396 | 109 | 1,954 | +18.1% |
| Hawaii | $555 | $1,732 | 18 | 140 | +16.5% |
| Nevada | $545 | $4,546 | 136 | 4,679 | +14.5% |
| New Jersey | $541 | $6,827 | 469 | 8,667 | +13.6% |
| Oregon | $535 | $2,436 | 134 | 4,617 | +12.3% |
| New York | $523 | $2,779 | 653 | 13,133 | +9.9% |
| Wyoming | $512 | $3,254 | 18 | 518 | +7.4% |
| Maryland | $509 | $3,008 | 306 | 12,180 | +6.8% |
| Colorado | $499 | $3,053 | 215 | 6,086 | +4.9% |
| Florida | $498 | $3,367 | 1,121 | 39,744 | +4.6% |
| Delaware | $497 | $2,758 | 56 | 2,137 | +4.3% |
| Arizona | $495 | $2,628 | 329 | 16,520 | +4.0% |
| Washington | $494 | $2,152 | 201 | 5,398 | +3.7% |
| Virginia | $493 | $1,935 | 190 | 7,695 | +3.6% |
| Kentucky | $486 | $2,039 | 141 | 5,920 | +2.1% |
| Georgia | $485 | $3,405 | 456 | 20,074 | +1.8% |
| Texas | $470 | $3,472 | 1,090 | 30,089 | -1.4% |
| Michigan | $464 | $2,164 | 367 | 6,826 | -2.6% |
| New Hampshire | $462 | $2,409 | 65 | 2,036 | -2.9% |
| Tennessee | $457 | $2,643 | 233 | 10,859 | -3.9% |
| Minnesota | $455 | $2,812 | 178 | 4,884 | -4.5% |
| Oklahoma | $454 | $1,539 | 137 | 5,297 | -4.7% |
| Rhode Island | $454 | $2,981 | 24 | 515 | -4.7% |
| New Mexico | $451 | $2,595 | 67 | 2,274 | -5.3% |
| Indiana | $450 | $3,187 | 273 | 7,420 | -5.6% |
| Nebraska | $449 | $2,392 | 84 | 2,382 | -5.8% |
| South Carolina | $448 | $2,063 | 157 | 7,167 | -5.9% |
| Utah | $448 | $1,526 | 144 | 4,533 | -5.9% |
| North Carolina | $442 | $1,999 | 331 | 8,522 | -7.1% |
| Pennsylvania | $442 | $2,194 | 490 | 11,513 | -7.2% |
| Arkansas | $440 | $1,854 | 139 | 7,803 | -7.5% |
| Alabama | $440 | $1,770 | 137 | 3,827 | -7.6% |
| Illinois | $438 | $2,837 | 396 | 9,960 | -8.1% |
| District of Columbia | $436 | $1,767 | 21 | 240 | -8.4% |
| Massachusetts | $429 | $2,025 | 251 | 5,689 | -9.9% |
| Mississippi | $429 | $2,417 | 97 | 6,103 | -9.9% |
| Iowa | $425 | $2,472 | 101 | 3,052 | -10.7% |
| Idaho | $422 | $1,857 | 62 | 2,139 | -11.4% |
| Louisiana | $422 | $2,964 | 205 | 8,629 | -11.4% |
| Montana | $413 | $1,623 | 39 | 1,341 | -13.4% |
| Kansas | $407 | $2,539 | 108 | 3,380 | -14.5% |
| North Dakota | $401 | $1,876 | 22 | 599 | -15.8% |
| Wisconsin | $394 | $4,296 | 213 | 5,397 | -17.2% |
| Ohio | $390 | $1,789 | 430 | 10,881 | -18.1% |
| Puerto Rico | $380 | $402 | 17 | 202 | -20.3% |
| Maine | $368 | $1,692 | 32 | 702 | -22.6% |
| Missouri | $362 | $2,185 | 175 | 4,515 | -23.9% |
| Vermont | $300 | $2,278 | 14 | 356 | -37.0% |
| South Dakota | $295 | $1,028 | 30 | 775 | -38.1% |
| West Virginia | $254 | $888 | 39 | 1,670 | -46.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber