How much does Medicare pay for CPT 00630?

Medicare allowed an average of $227.84 per service and paid $178.80 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2187.86, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00630?

Anesthesia for other procedure on lower spine. It was billed 18,567 times to 16,379 Medicare beneficiaries by 737 providers in 2024.

Does 00630 pay differently in an office than a hospital?

Yes. The allowed amount averaged $203.47 in an office setting and $233.70 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 00630 most?

Certified Registered Nurse Anesthetist (CRNA), with 9,671 services from 289 clinicians. Next are Anesthesiology, Anesthesiology Assistant, Pain Management.

CPT 00630

Anesthesia for other procedure on lower spine

$227.84Medicare-allowed amount per service, averaged across 18,567 services

Providers submitted

$2187.86

Asking price, not received

Medicare allowed

$227.84

The fee schedule figure

Medicare paid

$178.80

Balance is patient coinsurance

Providers submitted an average of $2187.86 for this code and Medicare allowed $227.84 — 9.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $178.80 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $203.47
Hospital / facility: $233.70

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 3,603 services were billed in an office setting and 14,964 in a facility.

Services: 18,567
Beneficiaries: 16,379
Providers billing it: 737
Total allowed: $4,230,305

What Medicare pays for CPT 00630

Across 18,567 services billed by 737 providers to 16,379 beneficiaries, Medicare allowed an average of $227.84 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 00630

Specialty	Services	Beneficiaries	Avg allowed	Providers
Certified Registered Nurse Anesthetist (CRNA)	9,671	7,833	$222.85	289
Anesthesiology	8,606	8,284	$234.83	430
Anesthesiology Assistant	141	141	$165.17	10
Pain Management	96	68	$182.39	4
Interventional Pain Management	30	30	$269.49	2
Internal Medicine	12	12	$236.72	1
Critical Care (Intensivists)	11	11	$223.88	1

00630 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	4,517	$207.84	$156.88	65
Texas	1,834	$241.02	$190.37	85
California	1,356	$278.06	$216.32	54
Pennsylvania	803	$211.31	$164.04	39
New Jersey	783	$217.24	$162.00	21
New York	604	$347.85	$244.44	31
South Carolina	595	$204.85	$163.43	28
Nevada	584	$204.95	$164.70	9
Oklahoma	536	$208.29	$168.47	23
North Carolina	536	$150.58	$121.35	26
Alabama	528	$157.17	$132.41	24
Tennessee	453	$227.29	$186.40	25
Louisiana	449	$242.24	$196.51	12
Massachusetts	405	$276.68	$215.07	28
Maryland	379	$238.46	$176.89	16
Mississippi	335	$213.37	$179.19	19
Illinois	330	$207.11	$157.19	22
Georgia	291	$203.15	$168.83	9
Arkansas	285	$266.43	$225.16	17
Ohio	268	$160.03	$126.58	17
Arizona	240	$332.36	$263.03	12
Kansas	218	$245.34	$205.04	14
Missouri	209	$252.57	$202.71	15
Virginia	190	$216.99	$171.19	14
Washington	186	$276.58	$215.58	9
Nebraska	177	$189.81	$159.63	10
Oregon	175	$289.78	$233.39	10
Indiana	148	$243.46	$200.43	10
Colorado	120	$237.01	$185.25	9
Utah	116	$184.11	$144.03	4
Michigan	103	$191.52	$152.54	7
Kentucky	94	$247.87	$198.93	7
North Dakota	86	$126.16	$103.80	5
Wyoming	81	$383.43	$314.05	5
New Hampshire	76	$285.26	$231.13	6
Iowa	72	$300.31	$239.99	4
Minnesota	64	$184.66	$147.55	3
Wisconsin	62	$220.46	$184.13	4
West Virginia	54	$221.78	$170.78	3
Delaware	39	$247.20	$200.47	3
Maine	39	$281.84	$228.79	3
Idaho	36	$275.70	$231.05	1
District of Columbia	27	$233.15	$170.74	2
New Mexico	22	$264.10	$212.04	2
South Dakota	15	$316.15	$251.57	1
Vermont	12	$278.46	$223.09	1
Rhode Island	12	$162.66	$113.53	1
Hawaii	12	$349.70	$279.76	1
Connecticut	11	$201.86	$159.24	1

Related codes

00670Anesthesia for extensive surgery on spine$387.55
00600Anesthesia for other procedure on upper spine$252.45

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.