Colorado · 22532

Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone in Colorado

Colorado Medicare Avg
$624.71
3% below national avg
National Medicare Avg
$646.13
All states combined
Billed Charge (CO)
$4,923.41
What providers submit
Est. Commercial (CO)
$1,797.91
National avg: $1,812.55
Est. Cash / Self-Pay (CO)
$1,940.21
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

26
Services in CO
20
Providers
N/A
Min Payment
N/A
Max Payment

Colorado Pricing in Context

In Colorado, CPT code 22532 (Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone) carries an average Medicare payment of $624.71 — 3% below the national benchmark of $646.13. 20 providers across the state submitted claims for this procedure in 2023, performing 26 total services. Individual payments in CO ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Colorado is $4,923.41, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Colorado sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Musculoskeletal Surgery procedures, the estimated commercial insurance price in Colorado lands near $1,797.91, with self-pay cash prices typically around $1,940.21. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone cost in Colorado?

The average Medicare payment for Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone in Colorado is $624.71, which is 3% below the national average of $646.13. Providers in CO typically bill $4,923.41 for this procedure.

What does Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone cost with insurance in Colorado?

With commercial insurance in Colorado, Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone costs an estimated $1,797.91. Without insurance, the estimated cash price is $1,940.21. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone in Colorado?

20 providers in Colorado billed Medicare for Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone in 2023, performing 26 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone cheaper in Colorado than the national average?

Yes — Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone costs 3% below the national average in Colorado. The state average Medicare payment is $624.71 compared to $646.13 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial