Cost analysis for CPT 64628 — Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones
Average Medicare Payment
$3343.97
2023 data
Total Payments (2023)
$21.3M
Services (2023)
5.5K
Price Change (2022–2023)
+8.4%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2022 | $3085.52 | $8.5M | 2.5K | — |
| 2023 | $3343.97 | $21.3M | 5.5K | +8.4% |
The most expensive state pays 3.4x more than the cheapest for this procedure. OR averages $5154.85 vs OK at $1508.53.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| OR | $5154.85 | $876.3K | 170 | 7 |
| AZ | $4738.20 | $1.2M | 247 | 15 |
| CA | $4630.01 | $2.3M | 490 | 17 |
| GA | $4611.03 | $747.0K | 162 | 8 |
| PA | $4359.31 | $1.3M | 304 | 10 |
| FL | $4253.36 | $4.5M | 1.1K | 47 |
| CO | $4162.82 | $886.7K | 213 | 9 |
| TX | $4060.72 | $2.9M | 722 | 32 |
| NE | $3991.12 | $427.0K | 107 | 3 |
| UT | $3832.66 | $1.6M | 413 | 17 |
| SC | $3155.41 | $539.6K | 171 | 5 |
| NY | $2997.44 | $743.4K | 248 | 13 |
| MS | $2966.11 | $335.2K | 113 | 4 |
| OK | $1508.53 | $211.2K | 140 | 6 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Zion Eye Institute, Inc | Ambulatory Surgical Center | UT | $828.3K | 110 | $7530.41 |
| Norcal Anesthesia And Pain Affiliates, Inc. | Ambulatory Surgical Center | CA | $686.4K | 85 | $8075.24 |
| Abilene Spine & Joint Surgery Center Pa | Ambulatory Surgical Center | TX | $673.1K | 94 | $7160.92 |
| Central Texas Day Surgery Center Limited Partnership | Ambulatory Surgical Center | TX | $646.7K | 84 | $7699.10 |
| Main Line Spine Surgery Center, Llc | Ambulatory Surgical Center | PA | $512.7K | 67 | $7652.47 |
| Southwest Lincoln Surgery Center, Llc | Ambulatory Surgical Center | NE | $409.8K | 54 | $7589.42 |
| Harmony Surgery Center, Llc | Ambulatory Surgical Center | CO | $398.8K | 52 | $7668.30 |
| Murdock Ambulatory Surgery Center Llc | Ambulatory Surgical Center | FL | $393.2K | 55 | $7149.86 |
| Stockton Outpatient Surgery Center Llc | Ambulatory Surgical Center | CA | $359.6K | 36 | $9988.78 |
| Phycare Asc, Llc | Ambulatory Surgical Center | PA | $355.7K | 46 | $7731.69 |
| Nspc Surgery Center Of Maryland Llc | Ambulatory Surgical Center | MD | $352.1K | 45 | $7825.27 |
| Total Pain Care Llc | Ambulatory Surgical Center | MS | $313.2K | 47 | $6663.16 |
| Advanced Surgery Center Of Lancaster, Llc | Ambulatory Surgical Center | PA | $312.5K | 42 | $7440.40 |
| North Shore Surgi-Center Inc | Ambulatory Surgical Center | NY | $312.5K | 35 | $8927.45 |
| The Southeastern Spine Institute Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | SC | $304.4K | 41 | $7424.69 |
| Physicians Surgery Center Llc | Ambulatory Surgical Center | FL | $302.5K | 41 | $7378.29 |
| Park Center For Procedures Llc | Ambulatory Surgical Center | FL | $302.4K | 41 | $7374.62 |
| Old Moultrie Surgical Center Inc | Ambulatory Surgical Center | FL | $298.4K | 42 | $7104.78 |
| Surgery Center Of Naples, Llc | Ambulatory Surgical Center | FL | $298.4K | 41 | $7278.01 |
| Sarasota Ambulatory Surgery Center Ltd | Ambulatory Surgical Center | FL | $291.4K | 39 | $7472.97 |
The data suggests significant pricing inconsistencies for CPT 64628. With a 3.4x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
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.