How much does Medicare pay for HCPCS 0275T?

Medicare allowed an average of $2883.09 per service and paid $2294.07 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $12,547, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code 0275T?

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin. It was billed 20,041 times to 19,293 Medicare beneficiaries by 703 providers in 2024.

Does 0275T pay differently in an office than a hospital?

Yes. The allowed amount averaged $715.35 in an office setting and $2891.89 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 0275T most?

Ambulatory Surgical Center, with 9,974 services from 296 clinicians. Next are Pain Management, Anesthesiology, Interventional Pain Management.

HCPCS 0275T

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin

$2883.09Medicare-allowed amount per service, averaged across 20,041 services

Providers submitted

$12,547

Asking price, not received

Medicare allowed

$2883.09

The fee schedule figure

Medicare paid

$2294.07

Balance is patient coinsurance

Providers submitted an average of $12,547 for this code and Medicare allowed $2883.09 — 4.4× 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 $2294.07 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $715.35
Hospital / facility: $2891.89

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 81 services were billed in an office setting and 19,960 in a facility.

Services: 20,041
Beneficiaries: 19,293
Providers billing it: 703
Total allowed: $57,780,007

What Medicare pays for HCPCS 0275T

Across 20,041 services billed by 703 providers to 19,293 beneficiaries, Medicare allowed an average of $2883.09 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 0275T

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	9,974	9,605	$4941.84	296
Pain Management	3,544	3,439	$832.27	138
Anesthesiology	2,600	2,510	$839.60	97
Interventional Pain Management	2,184	2,072	$876.29	92
Physical Medicine and Rehabilitation	1,660	1,588	$833.03	75
Neurology	35	35	$880.44	2
Diagnostic Radiology	19	19	$609.19	1
Internal Medicine	13	13	$617.95	1
Family Practice	12	12	$879.86	1

0275T 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	3,111	$3075.05	$2581.08	103
Pennsylvania	2,394	$2758.95	$2227.37	53
Maryland	1,702	$3221.49	$2582.28	44
New Jersey	1,554	$3385.14	$2538.42	52
Arizona	1,312	$3127.75	$2559.49	44
California	1,284	$3363.66	$2290.52	47
Texas	1,035	$2694.60	$2209.12	42
New York	929	$2738.74	$2078.59	34
Georgia	902	$2874.49	$2334.24	41
Missouri	600	$1957.66	$1601.10	20
Mississippi	449	$2179.06	$1936.45	11
Illinois	354	$2447.76	$1924.20	14
Indiana	347	$3054.09	$2507.14	14
Ohio	312	$2469.64	$2099.87	15
Michigan	290	$2923.24	$2442.37	13
North Carolina	286	$2734.90	$2338.94	8
Kansas	257	$2295.21	$1879.27	7
Tennessee	244	$2591.02	$2295.15	9
Nebraska	242	$2904.71	$2377.48	13
Washington	219	$3067.35	$2249.01	9
South Carolina	203	$2084.12	$1770.14	8
Virginia	191	$1530.04	$1256.11	10
Massachusetts	182	$3533.94	$2654.94	8
Arkansas	172	$2853.45	$2428.22	8
Oregon	145	$3190.85	$2357.11	6
Louisiana	142	$2282.93	$1977.46	7
Alabama	127	$1539.37	$1313.83	6
Idaho	125	$2104.91	$1732.26	6
Oklahoma	112	$1791.09	$1516.72	4
Iowa	111	$1676.78	$1392.39	8
Wisconsin	89	$554.32	$435.93	6
Minnesota	86	$3692.30	$2859.43	3
Nevada	82	$3953.73	$2981.72	5
Delaware	70	$3489.11	$2715.37	4
West Virginia	64	$2086.13	$1799.43	3
New Hampshire	62	$2556.16	$2029.23	2
Connecticut	53	$3721.75	$2789.60	3
Colorado	40	$4949.59	$3967.19	2
District of Columbia	38	$1029.41	$812.23	2
South Dakota	34	$2730.18	$2314.17	2
North Dakota	34	$1888.26	$1578.11	3
Kentucky	17	$550.76	$440.51	1
Montana	15	$4549.51	$3954.62	1
New Mexico	13	$579.70	$432.62	1
Rhode Island	11	$4982.21	$3967.18	1

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.