Pennsylvania · 63082

Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment in Pennsylvania

Pennsylvania Medicare Avg
$139.09
0% above national avg
National Medicare Avg
$138.71
All states combined
Billed Charge (PA)
$1,663.79
What providers submit
Est. Commercial (PA)
$383.34
National avg: $389.39
Est. Cash / Self-Pay (PA)
$588.23
Typical self-pay discount

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

57
Services in PA
29
Providers
N/A
Min Payment
N/A
Max Payment

Pennsylvania Pricing in Context

In Pennsylvania, CPT code 63082 (Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment) carries an average Medicare payment of $139.09 — 0% above the national benchmark of $138.71. 29 providers across the state submitted claims for this procedure in 2023, performing 57 total services. Individual payments in PA 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 Pennsylvania is $1,663.79, 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 Pennsylvania sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Nervous System Surgery procedures, the estimated commercial insurance price in Pennsylvania lands near $383.34, with self-pay cash prices typically around $588.23. 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 Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment cost in Pennsylvania?

The average Medicare payment for Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment in Pennsylvania is $139.09, which is 0% above the national average of $138.71. Providers in PA typically bill $1,663.79 for this procedure.

What does Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment cost with insurance in Pennsylvania?

With commercial insurance in Pennsylvania, Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment costs an estimated $383.34. Without insurance, the estimated cash price is $588.23. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment in Pennsylvania?

29 providers in Pennsylvania billed Medicare for Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment in 2023, performing 57 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment cheaper in Pennsylvania than the national average?

No — Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior Approach, Each Additional Segment costs 0% above the national average in Pennsylvania. The state average Medicare payment is $139.09 compared to $138.71 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