63685

Insertion of spinal neurostimulator generator or receiver

Medicare pricing data for 6,980 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $162 in Maine to $12,428 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

Insertion of spinal neurostimulator generator or receiver (HCPCS code 63685) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7,439, but hospitals typically charge $20,011 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1,488

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7,439, your out-of-pocket cost would be approximately $1,488. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7,439
Average Hospital Charge
$20,011
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$20,010.90
Medicare Allowed$7,439.34
Medicare Payment$5,927.67

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $5,928 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$12,428$26,692823+67.1%
California$11,052$23,0595663,541+48.6%
Maryland$10,747$37,2601511,142+44.5%
Oregon$10,144$25,185133952+36.4%
Nevada$9,909$20,610109864+33.2%
Arizona$9,839$24,6542431,976+32.3%
Minnesota$9,391$25,90290803+26.2%
Alaska$9,375$20,73325130+26.0%
Indiana$8,961$21,9861651,344+20.5%
Washington$8,745$22,912126918+17.5%
New Jersey$8,711$23,838175836+17.1%
Nebraska$8,708$21,37151345+17.1%
Mississippi$8,491$22,98658793+14.1%
Texas$8,417$23,7176876,075+13.1%
Colorado$7,862$20,735102517+5.7%
Florida$7,707$23,7456324,257+3.6%
Idaho$7,695$15,90242286+3.4%
Illinois$7,503$21,1561991,147+0.8%
Iowa$7,360$21,74344188-1.1%
Georgia$7,241$21,5783041,584-2.7%
Arkansas$7,240$21,39272556-2.7%
Oklahoma$7,156$18,1941151,189-3.8%
Utah$7,000$22,00891896-5.9%
Rhode Island$6,937$15,155847-6.8%
Connecticut$6,550$19,15555134-12.0%
Wisconsin$6,537$18,105133686-12.1%
Tennessee$6,529$15,4531441,337-12.2%
Michigan$6,189$18,8062111,233-16.8%
Louisiana$6,057$15,935143797-18.6%
Missouri$5,859$13,3541541,159-21.2%
Pennsylvania$5,536$14,3282481,691-25.6%
North Carolina$5,284$15,7542311,723-29.0%
New Hampshire$5,236$15,95249215-29.6%
Ohio$5,205$13,1722371,307-30.0%
South Carolina$5,167$14,3031331,258-30.5%
Kentucky$4,965$16,09694559-33.3%
Kansas$4,933$17,18196853-33.7%
New Mexico$4,654$13,2372477-37.4%
North Dakota$4,372$9,56819114-41.2%
Delaware$4,148$10,03733185-44.2%
West Virginia$4,065$8,49033173-45.4%
South Dakota$4,029$9,96723146-45.8%
New York$3,927$9,6322491,031-47.2%
Alabama$3,396$10,34489567-54.4%
Massachusetts$3,200$9,309106470-57.0%
Virginia$3,024$8,752129829-59.3%
Wyoming$2,652$5,3861575-64.4%
Montana$2,197$6,78226159-70.5%
District of Columbia$225$1,748952-97.0%
Maine$162$1,2201037-97.8%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber