Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint
Medicare pricing data for 9,867 providers across 52 states
This procedure has a 5.7x markup — hospitals charge $967.55 but Medicare allows only $168.58. Uninsured patients may face bills 5.7 times higher than what insurance negotiates. Prices vary significantly by location — from $75 in West Virginia to $261 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, each additional facet joint (HCPCS code 64636) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $168.58, but hospitals typically charge $967.55 — a 5.7x 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 $168.58, your out-of-pocket cost would be approximately $33.72. 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 5.7x more than what Medicare allows for this procedure. Medicare actually pays $134.34 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $261 | $3,197 | 23 | 249 | +54.5% |
| Connecticut | $255 | $1,138 | 91 | 1,370 | +51.1% |
| Virginia | $254 | $876 | 179 | 7,703 | +50.6% |
| Hawaii | $235 | $429 | 14 | 82 | +39.6% |
| Kentucky | $231 | $747 | 130 | 4,617 | +37.1% |
| New York | $228 | $1,193 | 585 | 9,524 | +35.2% |
| Oklahoma | $217 | $635 | 131 | 6,006 | +28.8% |
| Utah | $208 | $586 | 126 | 3,741 | +23.5% |
| North Carolina | $208 | $894 | 314 | 8,604 | +23.3% |
| Arizona | $206 | $773 | 267 | 10,643 | +21.9% |
| Michigan | $201 | $780 | 336 | 6,214 | +19.4% |
| Florida | $201 | $1,065 | 931 | 30,070 | +19.3% |
| South Carolina | $193 | $862 | 148 | 6,318 | +14.3% |
| Alabama | $184 | $692 | 123 | 3,927 | +9.4% |
| Puerto Rico | $182 | $189 | 16 | 214 | +7.8% |
| Texas | $173 | $957 | 928 | 23,623 | +2.7% |
| New Jersey | $171 | $4,125 | 352 | 5,091 | +1.5% |
| Nevada | $170 | $2,150 | 102 | 2,181 | +0.8% |
| Massachusetts | $168 | $920 | 235 | 4,666 | -0.1% |
| District of Columbia | $167 | $978 | 20 | 254 | -1.2% |
| Illinois | $166 | $1,125 | 342 | 7,351 | -1.5% |
| Delaware | $165 | $1,077 | 46 | 1,279 | -1.9% |
| Colorado | $162 | $814 | 171 | 3,862 | -3.9% |
| New Mexico | $161 | $768 | 62 | 1,896 | -4.3% |
| New Hampshire | $158 | $922 | 55 | 1,359 | -6.3% |
| Oregon | $158 | $855 | 101 | 2,038 | -6.4% |
| Tennessee | $157 | $690 | 188 | 6,183 | -6.8% |
| California | $156 | $1,075 | 796 | 14,592 | -7.3% |
| Maine | $150 | $671 | 31 | 616 | -11.0% |
| Washington | $147 | $670 | 168 | 2,801 | -13.0% |
| Pennsylvania | $147 | $709 | 414 | 8,416 | -13.1% |
| Wyoming | $143 | $894 | 12 | 164 | -15.3% |
| Rhode Island | $135 | $946 | 21 | 264 | -20.1% |
| Arkansas | $131 | $1,187 | 118 | 5,530 | -22.4% |
| Indiana | $129 | $931 | 215 | 4,983 | -23.3% |
| Nebraska | $129 | $752 | 68 | 2,121 | -23.4% |
| Ohio | $125 | $540 | 386 | 7,727 | -25.9% |
| Iowa | $119 | $861 | 90 | 2,157 | -29.2% |
| Vermont | $118 | $1,208 | 14 | 335 | -29.9% |
| Maryland | $115 | $704 | 211 | 6,973 | -31.7% |
| Missouri | $112 | $645 | 156 | 4,187 | -33.7% |
| Georgia | $109 | $905 | 336 | 9,690 | -35.5% |
| Mississippi | $106 | $800 | 78 | 3,541 | -36.9% |
| Idaho | $104 | $725 | 50 | 1,106 | -38.4% |
| Louisiana | $102 | $955 | 168 | 6,033 | -39.4% |
| Minnesota | $102 | $822 | 144 | 2,830 | -39.7% |
| North Dakota | $93 | $791 | 18 | 407 | -44.9% |
| Kansas | $93 | $642 | 89 | 2,245 | -45.0% |
| Wisconsin | $91 | $1,258 | 173 | 3,304 | -45.8% |
| South Dakota | $90 | $357 | 27 | 663 | -46.8% |
| Montana | $88 | $531 | 30 | 568 | -47.9% |
| West Virginia | $75 | $258 | 36 | 1,714 | -55.3% |
⚠️ 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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