Ohio · 22532

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

Ohio Medicare Avg
$556.13
14% below national avg
National Medicare Avg
$646.13
All states combined
Billed Charge (OH)
$3,876.92
What providers submit
Est. Commercial (OH)
$1,463.38
National avg: $1,812.55
Est. Cash / Self-Pay (OH)
$1,588.79
Typical self-pay discount

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

18
Services in OH
14
Providers
N/A
Min Payment
N/A
Max Payment

Ohio Pricing in Context

In Ohio, CPT code 22532 (Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone) carries an average Medicare payment of $556.13 — 14% below the national benchmark of $646.13. 14 providers across the state submitted claims for this procedure in 2023, performing 18 total services. Individual payments in OH 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 Ohio is $3,876.92, 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 Ohio 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 Ohio lands near $1,463.38, with self-pay cash prices typically around $1,588.79. 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 Ohio?

The average Medicare payment for Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone in Ohio is $556.13, which is 14% below the national average of $646.13. Providers in OH typically bill $3,876.92 for this procedure.

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

With commercial insurance in Ohio, Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone costs an estimated $1,463.38. Without insurance, the estimated cash price is $1,588.79. 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 Ohio?

14 providers in Ohio billed Medicare for Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone in 2023, performing 18 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 Ohio than the national average?

Yes — Fusion Of Middle Spine Bone Through Side With Partial Removal Of Disc, 1 Bone costs 14% below the national average in Ohio. The state average Medicare payment is $556.13 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