Cost analysis for CPT 22612 — Fusion of spine in lower back
Average Medicare Payment
$1147.12
2023 data
Total Payments (2023)
$51.6M
Services (2023)
44.6K
Price Change (2014–2023)
+40.0%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $819.21 | $38.9M | 47.3K | — |
| 2015 | $823.19 | $40.4M | 48.3K | +0.5% |
| 2016 | $814.99 | $42.6M | 51.6K | -1.0% |
| 2017 | $803.54 | $42.2M | 51.8K | -1.4% |
| 2018 | $829.72 | $42.8M | 51.3K | +3.3% |
| 2019 | $844.10 | $43.1M | 50.5K | +1.7% |
| 2020 | $873.28 | $37.9M | 42.2K | +3.5% |
| 2021 | $932.82 | $43.9M | 45.2K | +6.8% |
| 2022 | $952.42 | $45.2M | 45.5K | +2.1% |
| 2023 | $1147.12 | $51.6M | 44.6K | +20.4% |
The most expensive state pays 4.2x more than the cheapest for this procedure. NJ averages $2633.32 vs SD at $626.12.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NJ | $2633.32 | $1.9M | 733 | 36 |
| MS | $2428.62 | $723.7K | 298 | 13 |
| KS | $1737.83 | $2.1M | 1.2K | 37 |
| MD | $1576.68 | $2.4M | 1.5K | 64 |
| AR | $1477.89 | $218.7K | 148 | 10 |
| OR | $1391.14 | $445.2K | 320 | 16 |
| TX | $1383.35 | $6.1M | 4.4K | 200 |
| MI | $1352.54 | $1.0M | 773 | 34 |
| NV | $1347.41 | $442.0K | 328 | 16 |
| CA | $1329.35 | $6.6M | 5.0K | 209 |
| DC | $1264.28 | $196.0K | 155 | 5 |
| PA | $1259.42 | $2.2M | 1.8K | 76 |
| ID | $1248.07 | $526.7K | 422 | 21 |
| WI | $1242.54 | $507.0K | 408 | 26 |
| MN | $1202.96 | $763.9K | 635 | 29 |
| FL | $1176.29 | $3.5M | 3.0K | 130 |
| MA | $1144.73 | $789.9K | 690 | 36 |
| NY | $1140.60 | $1.1M | 976 | 63 |
| AZ | $1138.61 | $1.3M | 1.2K | 53 |
| WV | $1106.12 | $125.0K | 113 | 6 |
| NE | $1059.21 | $314.6K | 297 | 14 |
| UT | $1056.35 | $679.2K | 643 | 27 |
| GA | $1054.79 | $1.4M | 1.3K | 62 |
| OH | $1010.55 | $2.1M | 2.1K | 89 |
| AL | $1007.37 | $1.1M | 1.1K | 43 |
| CO | $958.07 | $773.2K | 807 | 32 |
| LA | $946.16 | $752.2K | 795 | 30 |
| IL | $942.63 | $773.0K | 820 | 35 |
| SC | $931.15 | $999.1K | 1.1K | 50 |
| CT | $909.60 | $404.8K | 445 | 29 |
| NC | $884.89 | $1.4M | 1.6K | 73 |
| IN | $881.47 | $811.8K | 921 | 46 |
| KY | $869.89 | $374.1K | 430 | 21 |
| TN | $865.20 | $1.3M | 1.5K | 62 |
| RI | $859.83 | $152.2K | 177 | 10 |
| VA | $838.38 | $1.1M | 1.3K | 61 |
| MO | $820.34 | $598.8K | 730 | 33 |
| MT | $811.77 | $95.0K | 117 | 6 |
| OK | $746.69 | $1.0M | 1.3K | 55 |
| DE | $735.32 | $592.7K | 806 | 20 |
| WA | $724.49 | $605.7K | 836 | 45 |
| IA | $698.29 | $519.5K | 744 | 24 |
| SD | $626.12 | $108.9K | 174 | 11 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Jasper Ambulatory Surgical Center Llc | Ambulatory Surgical Center | NJ | $1.1M | 87 | $12879.17 |
| Nspc Surgery Center Of Maryland Llc | Ambulatory Surgical Center | MD | $864.5K | 71 | $12175.90 |
| Ky Advanced Surgical Center Inc | Ambulatory Surgical Center | CA | $673.5K | 51 | $13205.50 |
| Synergy Surgical Center, Llc | Ambulatory Surgical Center | CA | $607.8K | 42 | $14472.07 |
| Psa Ambulatory Surgery Center Of Killeen Llc | Ambulatory Surgical Center | TX | $582.2K | 47 | $12386.91 |
| Physicians' Surgery Center, Llc | Ambulatory Surgical Center | KS | $549.7K | 46 | $11949.23 |
| Santa Rosa Ambulatory Surgical Center Medical Group Inc | Ambulatory Surgical Center | CA | $465.7K | 33 | $14112.00 |
| Coral Ridge Outpatient Center Llc | Ambulatory Surgical Center | FL | $396.9K | 33 | $12026.71 |
| Surgical Clinic Solutions, Llc | Ambulatory Surgical Center | AL | $382.4K | 34 | $11248.30 |
| Pain, Spine & Rehab.,a.S.C.,p.A. | Ambulatory Surgical Center | KS | $380.5K | 34 | $11190.62 |
| Flint Region Asc | Ambulatory Surgical Center | MI | $364.6K | 29 | $12572.56 |
| Central Texas Day Surgery Center Limited Partnership | Ambulatory Surgical Center | TX | $353.3K | 29 | $12182.09 |
| Bva United Llc | Ambulatory Surgical Center | TX | $311.6K | 25 | $12462.51 |
| Ku Medwest Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | KS | $310.9K | 26 | $11956.75 |
| Advanced Surgery Center Of Lancaster, Llc | Ambulatory Surgical Center | PA | $302.3K | 26 | $11628.22 |
| Nura Surgical Center Llc | Ambulatory Surgical Center | MN | $297.5K | 23 | $12936.85 |
| Methodist Mansfield Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | TX | $270.5K | 22 | $12296.71 |
| Legent Outpatient Surgery Euless, Llc | Ambulatory Surgical Center | TX | $258.0K | 21 | $12287.16 |
| Abilene Spine & Joint Surgery Center Pa | Ambulatory Surgical Center | TX | $254.1K | 22 | $11548.10 |
| Northern Ohio Surgery Center, Llc | Ambulatory Surgical Center | OH | $247.0K | 21 | $11760.66 |
The data suggests significant pricing inconsistencies for CPT 22612. With a 4.2x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have risen 40.0% since 2014, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.