Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc
Medicare pricing data for 9,676 providers across 51 states
This procedure has a 5.9x markup — hospitals charge $7,807 but Medicare allows only $1,326. Uninsured patients may face bills 5.9 times higher than what insurance negotiates. Prices vary significantly by location — from $873 in South Dakota to $2,654 in Hawaii. 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
Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc (HCPCS code 22551) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,326, but hospitals typically charge $7,807 — a 5.9x 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 $1,326, your out-of-pocket cost would be approximately $265.15. 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 5.9x more than what Medicare allows for this procedure. Medicare actually pays $1,057 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Hawaii | $2,654 | $7,682 | 15 | 45 | +100.2% |
| Mississippi | $2,312 | $14,618 | 73 | 725 | +74.4% |
| Maryland | $1,770 | $7,864 | 207 | 1,390 | +33.5% |
| Oregon | $1,769 | $7,630 | 147 | 797 | +33.4% |
| Washington | $1,577 | $5,425 | 256 | 1,090 | +19.0% |
| District of Columbia | $1,471 | $5,505 | 28 | 139 | +11.0% |
| Michigan | $1,453 | $10,127 | 312 | 1,342 | +9.6% |
| Florida | $1,451 | $9,124 | 754 | 4,672 | +9.4% |
| Rhode Island | $1,450 | $10,486 | 28 | 84 | +9.4% |
| New Hampshire | $1,446 | $8,882 | 54 | 252 | +9.1% |
| Ohio | $1,446 | $6,422 | 368 | 1,742 | +9.0% |
| Arizona | $1,413 | $7,347 | 246 | 1,487 | +6.6% |
| Puerto Rico | $1,405 | $3,306 | 13 | 44 | +6.0% |
| Illinois | $1,384 | $10,554 | 307 | 1,546 | +4.4% |
| Arkansas | $1,383 | $4,747 | 78 | 664 | +4.3% |
| New York | $1,375 | $13,082 | 474 | 1,803 | +3.7% |
| Connecticut | $1,373 | $9,093 | 155 | 447 | +3.6% |
| California | $1,349 | $8,006 | 700 | 3,379 | +1.7% |
| Tennessee | $1,343 | $5,344 | 231 | 1,455 | +1.3% |
| Pennsylvania | $1,336 | $7,615 | 372 | 1,324 | +0.8% |
| Nevada | $1,336 | $13,633 | 100 | 464 | +0.7% |
| South Carolina | $1,334 | $5,948 | 172 | 1,287 | +0.6% |
| Georgia | $1,320 | $8,342 | 308 | 1,892 | -0.5% |
| Massachusetts | $1,308 | $7,717 | 189 | 915 | -1.3% |
| Texas | $1,296 | $6,515 | 736 | 4,855 | -2.3% |
| Nebraska | $1,261 | $6,099 | 85 | 418 | -4.9% |
| North Carolina | $1,255 | $6,168 | 367 | 2,174 | -5.4% |
| Virginia | $1,241 | $5,825 | 244 | 1,603 | -6.4% |
| Alaska | $1,223 | $11,781 | 44 | 299 | -7.8% |
| Missouri | $1,207 | $6,370 | 217 | 1,193 | -9.0% |
| Indiana | $1,205 | $7,554 | 222 | 1,284 | -9.1% |
| Kentucky | $1,193 | $5,364 | 126 | 670 | -10.0% |
| Montana | $1,188 | $5,263 | 50 | 262 | -10.4% |
| New Jersey | $1,185 | $21,973 | 232 | 896 | -10.6% |
| Louisiana | $1,182 | $7,428 | 186 | 1,337 | -10.8% |
| Colorado | $1,151 | $5,669 | 244 | 1,290 | -13.2% |
| Utah | $1,118 | $4,674 | 110 | 488 | -15.6% |
| New Mexico | $1,112 | $5,646 | 32 | 140 | -16.1% |
| Delaware | $1,106 | $7,052 | 38 | 312 | -16.5% |
| Maine | $1,084 | $3,266 | 37 | 113 | -18.2% |
| Wisconsin | $1,058 | $16,413 | 141 | 480 | -20.2% |
| Wyoming | $1,057 | $9,174 | 25 | 101 | -20.3% |
| Alabama | $1,052 | $5,492 | 179 | 1,371 | -20.7% |
| Minnesota | $1,051 | $6,570 | 172 | 660 | -20.7% |
| West Virginia | $1,038 | $4,173 | 47 | 205 | -21.7% |
| Oklahoma | $1,034 | $4,528 | 126 | 1,069 | -22.0% |
| Iowa | $1,016 | $5,692 | 80 | 422 | -23.4% |
| Kansas | $996 | $4,182 | 101 | 704 | -24.9% |
| Idaho | $980 | $9,445 | 84 | 436 | -26.1% |
| North Dakota | $977 | $3,849 | 24 | 207 | -26.3% |
| South Dakota | $873 | $3,978 | 48 | 310 | -34.2% |
⚠️ 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