How Much Does Spinal Fusion Surgery (Lumbar, Posterior Approach) Cost?
Also known as: Arthrd pst tq 1ntrspc lumbar (CPT 22612)
Surgery to fuse vertebrae in the lower back (lumbar spine) from the back approach.
The total estimated cost of Spinal Fusion Surgery (Lumbar, Posterior Approach) (CPT 22612) is $30,143 to $83,730, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $1,468. Average Medicare total payment: $33,492.
Total Estimated Cost of Care
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.
Patient Guide: Spinal Fusion Surgery (Lumbar, Posterior Approach)
What you need to know before your appointment
What to Expect
Under general anesthesia, the surgeon makes an incision in your lower back, places bone graft and hardware to fuse the vertebrae, and may decompress nerves. Hospital stay is typically 2-4 days.
How Long Does It Take?
2-4 hours of surgery
Common Reasons Doctors Order This
Degenerative disc disease, spondylolisthesis (slipped vertebra), spinal instability, failed conservative treatment for severe back pain
How to Prepare
Stop blood thinners and smoking as directed. Fast after midnight. Prepare home for recovery (raised toilet seat, grab bars). Arrange 4-6 weeks of help.
Procedures Commonly Done Together
These procedures are frequently performed alongside Arthrd pst tq 1ntrspc lumbar
What Insurance Companies Actually Pay
Real negotiated rates from 15 hospitals across 6 states (from hospital price transparency filings)
| Insurance Company | Avg Rate | Range | Hospitals |
|---|---|---|---|
| Aetna | $7,565 | $2,408 - $28,367 | 9 |
| United | $8,915 | $4,257 - $28,551 | 10 |
| Cigna | $32,092 | $2,496 - $68,725 | 9 |
| Humana | $10,237 | $2,204 - $31,243 | 8 |
| BCBS | $31,081 | $7,404 - $46,413 | 5 |
| Superior Health Plan | $3,948 | $2,369 - $27,630 | 4 |
| KAISER FOUNDATION HEALTH PLAN, INC. | $38,387 | $22,222 - $69,590 | 5 |
| Molina Healthcare | $7,756 | $7,756 | 3 |
| Community Health Choice MCD | $7,897 | $7,897 | 3 |
| BCBS-TX | $16,212 | $8,926 - $22,849 | 2 |
| Wellpoint | $13,577 | $7,051 - $27,630 | 2 |
| Anthem | $64,480 | $55,676 - $67,716 | 2 |
How to Reduce Your Cost for Arthrd pst tq 1ntrspc lumbar
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.
Payment = Total RVU (43.94) x CF ($33.40) = $1,468
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Arthrd pst tq 1ntrspc lumbar cost?
The Medicare facility rate for Arthrd pst tq 1ntrspc lumbar is $1,468. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Arthrd pst tq 1ntrspc lumbar cost without insurance?
Without insurance, the cost of Arthrd pst tq 1ntrspc lumbar 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 lumbar?
Most commercial health insurance plans and Medicare cover Arthrd pst tq 1ntrspc lumbar 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.