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 15 spine procedures cost at ASCs and hospital outpatient departments:
1. Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling (63685)
ASC
Total cost: $24,266
Medicare pays: $19,413
Patient pays: $4,852
HOPD
Total cost: $29,816
Medicare pays: $28,258
Patient pays: $1,558
2. 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
3. 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
4. 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
5. 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
6. 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
7. Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed (63664)
ASC
Total cost: $9,966
Medicare pays: $7,973
Patient pays: $1,992
HOPD
Total cost: $12,143
Medicare pays: $10,478
Patient pays: $1,665
8. 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
9. 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
10. Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace (63075)
ASC
Total cost: $4,336
Medicare pays: $3,461
Patient pays: $864
HOPD
Total cost: $7,661
Medicare pays: $6,129
Patient pays: $1,532
11. Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic (63003)
ASC
Total cost: $4,200
Medicare pays: $3,360
Patient pays: $839
HOPD
Total cost: $7,535
Medicare pays: $6,028
Patient pays: $1,507
12. 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
13. 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
14. 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
15. Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar (62380)
ASC
Total cost: $2,929
Medicare pays: $2,343
Patient pays: $585
HOPD
Total cost: $6,264
Medicare pays: $5,011
Patient pays: $1,253
