62270

Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test

Medicare pricing data for 12,259 providers across 51 states

🤖AI Overview

This procedure has a 7.6x markup — hospitals charge $536.21 but Medicare allows only $70.16. Uninsured patients may face bills 7.6 times higher than what insurance negotiates. 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

Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test (HCPCS code 62270) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $70.16, but hospitals typically charge $536.21 — a 7.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.03

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $70.16, your out-of-pocket cost would be approximately $14.03. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$70.16
Average Hospital Charge
$536.21
Markup Ratio
7.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$536.21
Medicare Allowed$70.16
Medicare Payment$54.74

Hospitals charge 7.6x more than what Medicare allows for this procedure. Medicare actually pays $54.74 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Minnesota$100$660241706+42.8%
Delaware$90$6354985+28.3%
New York$86$7228601,833+22.7%
Alaska$81$1,0244670+15.4%
Georgia$79$557289592+12.8%
Arizona$79$594318587+11.9%
Florida$77$5396221,146+9.7%
Connecticut$76$572172360+8.7%
Wyoming$75$5832335+6.6%
New Jersey$74$550247458+5.6%
Missouri$73$497311610+4.5%
Texas$71$4676341,323+1.4%
California$71$6711,3682,512+1.1%
Pennsylvania$69$4685591,034-2.3%
Indiana$68$446209329-2.4%
Massachusetts$68$4595501,206-2.5%
New Hampshire$68$55784146-2.6%
Illinois$68$608441724-2.9%
Rhode Island$68$47585146-3.4%
Nevada$67$392113208-5.2%
District of Columbia$67$3394149-5.2%
Michigan$65$483417630-7.1%
Louisiana$65$506190274-7.7%
Maryland$64$360289611-8.2%
South Carolina$64$386233363-9.1%
Alabama$63$421119215-9.8%
Maine$62$30399146-11.0%
Oregon$62$413192242-11.1%
Washington$62$355263422-11.2%
Colorado$62$551297568-11.8%
Kentucky$62$506149208-11.9%
Virginia$62$393292496-11.9%
Montana$61$2995397-13.2%
Kansas$61$433104156-13.5%
North Carolina$60$420398711-14.0%
West Virginia$60$3486896-14.1%
Tennessee$60$431201380-14.5%
New Mexico$60$432100127-14.5%
Ohio$59$418370654-15.9%
Utah$59$445107146-16.1%
North Dakota$59$4952938-16.4%
Hawaii$58$3464053-16.9%
Mississippi$58$51977129-17.9%
Idaho$57$4195169-18.3%
Oklahoma$57$420188261-18.4%
Vermont$57$51361118-19.1%
South Dakota$57$3543872-19.4%
Wisconsin$56$1,117237399-20.2%
Iowa$56$651102177-20.4%
Arkansas$55$42891121-22.1%
Nebraska$52$41589159-25.9%

⚠️ 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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