RxDoctor Payments Data

CPT 22552

Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, each additional disc

$268.72Medicare-allowed amount per service, averaged across 13,783 services
Providers submitted
$1732.67

Asking price, not received

Medicare allowed
$268.72

The fee schedule figure

Medicare paid
$214.56

Balance is patient coinsurance

Providers submitted an average of $1732.67 for this code and Medicare allowed $268.726.4× 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 $214.56 (80%); the rest is the patient’s coinsurance and deductible.

Services
13,783

Medicare Part B, 2024

Beneficiaries
8,524
Providers billing it
522
Total allowed
$3,703,768

Services × allowed amount

What Medicare pays for CPT 22552

Across 13,783 services billed by 522 providers to 8,524 beneficiaries, Medicare allowed an average of $268.72 per service. That is 1.6 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 22552

SpecialtyServicesBeneficiariesAvg allowedProviders
Neurosurgery5,3183,320$374.32197
Orthopedic Surgery3,7872,329$378.67143
Physician Assistant3,6162,206$52.29143
Nurse Practitioner853538$51.2131
Otolaryngology8453$190.042
Neurology5129$314.012
Osteopathic Manipulative Medicine2113$368.221
Physical Medicine and Rehabilitation2012$59.301
General Surgery1813$262.881
Certified Clinical Nurse Specialist1511$53.761

22552 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.

StateServicesAllowedStandardized pmtProviders
Florida1,884$272.78$198.9266
Texas1,788$273.13$217.8067
Louisiana856$213.31$182.4926
California734$257.34$205.7723
North Carolina641$237.27$207.8118
Virginia635$266.99$225.7725
Maryland580$330.63$252.9320
Arizona517$294.52$244.5420
Tennessee509$266.33$238.9919
Illinois476$282.79$214.0714
Georgia448$274.00$221.2818
Oklahoma435$249.87$216.0919
Ohio371$280.97$234.2017
South Carolina351$253.63$215.4618
Arkansas287$257.71$234.7610
Kansas271$246.78$225.419
Colorado235$316.98$257.649
Alabama230$198.14$176.9112
New York217$358.45$263.4011
Missouri187$269.87$221.029
Alaska180$302.55$198.746
Delaware178$225.97$185.998
Michigan176$348.38$259.747
New Jersey170$290.64$214.438
Mississippi168$208.85$181.398
Washington138$338.14$274.666
Massachusetts122$349.93$275.725
Pennsylvania122$288.15$227.476
Minnesota120$167.25$150.495
North Dakota119$228.90$196.333
Indiana117$271.03$245.615
Montana82$297.23$237.214
Iowa65$235.90$210.083
Utah62$284.93$241.313
Oregon59$233.03$208.873
Wisconsin49$199.70$183.292
Idaho41$230.35$197.172
Nevada37$217.56$178.342
Nebraska26$304.97$314.331
AE24$51.58$41.891
New Hampshire22$380.50$316.291
District of Columbia19$394.67$264.941
Wyoming18$389.83$307.581
South Dakota17$346.54$308.661

Related codes

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.