How much does Medicare pay for CPT 22214?

Medicare allowed an average of $586.26 per service and paid $467.96 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5344.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 22214?

Incision or removal of lower spine bone segment. It was billed 5,657 times to 5,596 Medicare beneficiaries by 255 providers in 2024.

Which specialty bills 22214 most?

Orthopedic Surgery, with 2,711 services from 125 clinicians. Next are Neurosurgery, Physician Assistant, Nurse Practitioner.

CPT 22214

Incision or removal of lower spine bone segment

$586.26Medicare-allowed amount per service, averaged across 5,657 services

Providers submitted

$5344.13

Asking price, not received

Medicare allowed

$586.26

The fee schedule figure

Medicare paid

$467.96

Balance is patient coinsurance

Providers submitted an average of $5344.13 for this code and Medicare allowed $586.26 — 9.1× 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 $467.96 (80%); the rest is the patient’s coinsurance and deductible.

Services: 5,657
Beneficiaries: 5,596
Providers billing it: 255
Total allowed: $3,316,473

What Medicare pays for CPT 22214

Across 5,657 services billed by 255 providers to 5,596 beneficiaries, Medicare allowed an average of $586.26 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 22214

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	2,711	2,686	$738.46	125
Neurosurgery	1,487	1,464	$770.01	65
Physician Assistant	1,293	1,280	$104.74	58
Nurse Practitioner	135	135	$115.23	5
General Surgery	31	31	$597.48	2

22214 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
California	1,559	$577.74	$440.59	56
Illinois	429	$639.76	$447.14	20
Texas	371	$559.05	$449.10	18
Florida	367	$624.71	$450.51	13
Massachusetts	261	$669.77	$506.90	7
Colorado	252	$596.27	$463.11	14
Maryland	215	$687.83	$466.06	11
Tennessee	199	$482.60	$443.43	9
Nebraska	191	$429.73	$374.27	11
Oklahoma	186	$471.45	$401.29	8
Michigan	168	$606.74	$463.48	7
Georgia	163	$725.11	$560.80	5
Virginia	149	$604.38	$454.46	9
North Carolina	113	$625.27	$505.48	6
Arizona	113	$542.89	$439.00	8
Ohio	107	$520.85	$419.94	5
Indiana	87	$362.57	$334.52	4
New York	82	$693.56	$466.31	6
Arkansas	69	$411.98	$368.04	4
Pennsylvania	62	$626.22	$505.85	5
Alaska	57	$653.27	$459.74	4
Utah	54	$458.48	$377.71	2
Louisiana	45	$441.17	$371.57	2
Iowa	41	$651.69	$601.17	1
Missouri	40	$508.27	$385.15	3
Connecticut	38	$858.01	$602.94	2
District of Columbia	34	$864.16	$595.26	2
Oregon	29	$633.73	$511.85	2
Rhode Island	29	$708.59	$563.62	1
Alabama	28	$627.02	$584.15	2
Minnesota	25	$678.49	$588.25	2
Washington	22	$742.09	$595.64	1
New Hampshire	19	$104.50	$81.15	1
Delaware	16	$745.97	$597.97	1
Wyoming	13	$115.59	$95.63	1
South Carolina	13	$663.65	$562.65	1
Idaho	11	$690.90	$581.42	1

Related codes

22216Incision or removal of spine bone segment$276.84

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.