CPT 22630 Surgery - Musculoskeletal

How Much Does Lumbar Spinal Fusion with Interbody Device (Posterior) Cost?

Also known as: Arthrd pst tq 1ntrspc lum (CPT 22630)

Lumbar spinal fusion with an interbody device (cage) placed through a posterior (back) approach.

The total estimated cost of Lumbar Spinal Fusion with Interbody Device (Posterior) (CPT 22630) is $30,143 to $83,730, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $1,511. Average Medicare total payment: $33,492.

Total Estimated Cost of Care

$30,143 — $83,730

This estimate includes hospital facility fees, anesthesia, and supplies for an inpatient hospital stay. Based on CMS data for SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC (DRG 460), the average Medicare total payment is $33,492.

Surgeon/Physician Fee
$1,511
Hospital Facility Fee
$31,981
Anesthesia (est.)
$302
Important: The physician fee of $1,511 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost. View DRG 460 hospital costs.
Medicare Physician Fee (Facility Setting)
$1,511
Physician component only — CMS PFS 2026

Patient Guide: Lumbar Spinal Fusion with Interbody Device (Posterior)

What you need to know before your appointment

What to Expect

The surgeon places a spacer (cage) filled with bone graft between the vertebrae from a back approach to restore disc height and promote fusion, along with screws and rods.

How Long Does It Take?

3-5 hours of surgery

Common Reasons Doctors Order This

Severe disc degeneration, spondylolisthesis, recurrent disc herniation, spinal instability

How to Prepare

Stop smoking well before surgery (smoking prevents fusion). Fast after midnight. Prepare for 4-8 weeks of activity restrictions.

Procedures Commonly Done Together

These procedures are frequently performed alongside Arthrd pst tq 1ntrspc lum

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What Insurance Companies Actually Pay

Real negotiated rates from 15 hospitals across 6 states (from hospital price transparency filings)

Lowest
$1
Highest
$69,590
Average
$18,885
Insurance Company Avg Rate Range Hospitals
Aetna $7,565 $2,408 - $28,367 9
United $12,644 $4,969 - $28,551 10
Cigna $24,131 $2,496 - $68,725 7
Humana $11,060 $2,204 - $40,969 8
BCBS $45,373 $18,420 - $63,306 5
Superior Health Plan $3,948 $2,369 - $27,630 4
KAISER FOUNDATION HEALTH PLAN, INC. $38,387 $22,222 - $69,590 5
BCBS-TX $2,309 $1,238 - $3,169 2
Anthem $64,480 $55,676 - $67,716 2
BCBS - TN $1,120 $167 - $4,834 2
Multiplan $29,884 $29,884 2
BCBS - GA $31,162 $16,935 - $40,262 1
Average by State
TN: $9,960 (18) GA: $14,354 (19) TX: $14,893 (157) KY: $20,008 (7) CO: $34,804 (36) CA: $38,387 (15)
Disclaimer: These rates are from hospital Machine-Readable Files (MRFs) required by federal price transparency law. They reflect specific hospital-payer contracts and may not represent your actual cost, which depends on your plan, deductible, and network status. Data sourced from CommonSpirit Health, HCA Healthcare, and Kaiser Permanente filings.

How to Reduce Your Cost for Arthrd pst tq 1ntrspc lum

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

21.54
Work RVU
15.81
Practice Expense RVU
7.88
Malpractice RVU
45.23
Total RVU

Payment = Total RVU (45.23) x CF ($33.40) = $1,511

Frequently Asked Questions

How much does Arthrd pst tq 1ntrspc lum cost?

The Medicare facility rate for Arthrd pst tq 1ntrspc lum is $1,511. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Arthrd pst tq 1ntrspc lum cost without insurance?

Without insurance, the cost of Arthrd pst tq 1ntrspc lum can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Arthrd pst tq 1ntrspc lum?

Most commercial health insurance plans and Medicare cover Arthrd pst tq 1ntrspc lum when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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