How much does Medicare pay for HCPCS 0627T?

Medicare allowed an average of $5524.37 per service and paid $4398.91 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $22,852, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code 0627T?

Injection of cell or tissue-based material into spinal disc of lower back accessed through skin, first level. It was billed 6,695 times to 3,909 Medicare beneficiaries by 140 providers in 2024.

Does 0627T pay differently in an office than a hospital?

Yes. The allowed amount averaged $175.42 in an office setting and $5535.58 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 0627T most?

Ambulatory Surgical Center, with 3,738 services from 77 clinicians. Next are Interventional Pain Management, Pain Management, Anesthesiology.

HCPCS 0627T

Injection of cell or tissue-based material into spinal disc of lower back accessed through skin, first level

$5524.37Medicare-allowed amount per service, averaged across 6,695 services

Providers submitted

$22,852

Asking price, not received

Medicare allowed

$5524.37

The fee schedule figure

Medicare paid

$4398.91

Balance is patient coinsurance

Providers submitted an average of $22,852 for this code and Medicare allowed $5524.37 — 4.1× 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 $4398.91 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $175.42
Hospital / facility: $5535.58

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 14 services were billed in an office setting and 6,681 in a facility.

Services: 6,695
Beneficiaries: 3,909
Providers billing it: 140
Total allowed: $36,985,657

What Medicare pays for HCPCS 0627T

Across 6,695 services billed by 140 providers to 3,909 beneficiaries, Medicare allowed an average of $5524.37 per service. That is 1.7 services per beneficiary, so this is a code patients typically receive more than once. 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 0627T

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	3,738	2,170	$9818.60	77
Interventional Pain Management	1,472	810	$97.39	23
Pain Management	666	419	$94.28	22
Anesthesiology	522	332	$93.79	11
Physical Medicine and Rehabilitation	248	141	$97.86	6
Diagnostic Radiology	49	37	$88.95	1

0627T 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
Maryland	1,030	$7346.35	$6089.57	15
Mississippi	945	$4194.84	$3925.57	16
Georgia	938	$10,078	$8094.95	24
Texas	876	$4639.88	$3839.19	21
Louisiana	673	$3517.32	$3228.01	20
Florida	569	$5373.32	$4613.97	11
New Jersey	432	$5588.10	$4149.17	6
Virginia	340	$98.75	$78.42	2
Pennsylvania	331	$6489.06	$5241.45	11
Oklahoma	253	$3799.37	$3324.58	4
New York	111	$99.34	$77.88	1
Colorado	80	$7054.65	$5675.48	3
North Carolina	39	$5906.94	$5088.25	2
Arkansas	31	$4691.76	$4007.06	2
California	24	$94.80	$75.53	1
Utah	23	$92.65	$60.38	1

Related codes

0623TPreparation, transmission and computerized analysis of ct angiography$1530.85

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.