CMS' procedure price lookup tool enables users to compare average pay for several procedures in ASCs and hospital outpatient departments.
The tool shows national averages for the amount Medicare pays an ASC or hospital, as well as the national average copayment a patient without Medicare supplemental insurance owes in each setting.
Here's what 10 common spine procedures cost at ASCs and hospital outpatient departments:
Editorial note: This is not an exhaustive list. Prices include facility and physician fees.
1. Insertion of stabilizing or separating device into lower spine at single level with open decompression (22867)
ASC
Total cost: $13,265
Medicare pays: $10,612
Patient pays: $2,653
HOPD
Total cost: $16,966
Medicare pays: $15,354
Patient pays: $1,612
2. Insertion of artificial upper spine disc, anterior approach (22856)
ASC
Total cost: $13,515
Medicare pays: $10,812
Patient pays: $2,702
HOPD
Total cost: $17,655
Medicare pays: $15,905
Patient pays: $1,749
3. Insertion of stabilizing or separating device into lower spine at single level (22869)
ASC
Total cost: $10,337
Medicare pays: $8,270
Patient pays: $2,066
HOPD
Total cost: $12,363
Medicare pays: $10,863
Patient pays: $1,500
4. Fusion of lower spine bones, posterior or posterolateral approach (22612)
ASC
Total cost: $10,267
Medicare pays: $8,214
Patient pays: $2,053
HOPD
Total cost: $13,560
Medicare pays: $11,820
Patient pays: $1,740
5. Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 (22551)
ASC
Total cost: $10,201
Medicare pays: $8,160
Patient pays: $2,309
HOPD
Total cost: $13,682
Medicare pays: $11,917
Patient pays: $1,764
6. Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 (22554)
ASC
Total cost: $9,738
Medicare pays: $7,789
Patient pays: $1,947
HOPD
Total cost: $13,211
Medicare pays: $11,540
Patient pays: $1,670
7. Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed (63663)
ASC
Total cost: $4,882
Medicare pays: $3,905
Patient pays: $975
HOPD
Total cost: $6,656
Medicare pays: $5,324
Patient pays: $1,330
8. Partial removal of upper spine bone with release of spinal cord and/or nerves (63045)
ASC
Total cost: $4,145
Medicare pays: $3,315
Patient pays: $828
HOPD
Total cost: $7,323
Medicare pays: $5,858
Patient pays: $1,464
9. Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar (63047)
ASC
Total cost: $3,954
Medicare pays: $3,163
Patient pays: $790
HOPD
Total cost: $7,132
Medicare pays: $5,706
Patient pays: $1,426
10. Partial removal of bone with release of spinal cord or spinal nerves of one interspace in lower spine (63030)
ASC
Total cost: $3,817
Medicare pays: $3,053
Patient pays: $762
HOPD
Total cost: $6,995
Medicare pays: $5,596
Patient pays: $1,398