How much does Medicare pay for CPT 22610?

Medicare allowed an average of $673.40 per service and paid $537.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4904.01, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 22610?

Fusion of spine in upper back. It was billed 1,348 times to 1,285 Medicare beneficiaries by 81 providers in 2024.

Which specialty bills 22610 most?

Neurosurgery, with 639 services from 40 clinicians. Next are Orthopedic Surgery, Physician Assistant, Nurse Practitioner.

CPT 22610

Fusion of spine in upper back

$673.40Medicare-allowed amount per service, averaged across 1,348 services

Providers submitted

$4904.01

Asking price, not received

Medicare allowed

$673.40

The fee schedule figure

Medicare paid

$537.59

Balance is patient coinsurance

Providers submitted an average of $4904.01 for this code and Medicare allowed $673.40 — 7.3× 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 $537.59 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,348
Beneficiaries: 1,285
Providers billing it: 81
Total allowed: $907,743

What Medicare pays for CPT 22610

Across 1,348 services billed by 81 providers to 1,285 beneficiaries, Medicare allowed an average of $673.40 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 22610

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	639	610	$781.53	40
Orthopedic Surgery	530	507	$735.28	32
Physician Assistant	148	139	$100.08	7
Nurse Practitioner	31	29	$123.73	2

22610 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	286	$538.01	$406.76	11
Tennessee	115	$493.28	$423.72	7
Texas	106	$690.56	$538.09	8
Maryland	101	$854.43	$607.87	7
Oklahoma	82	$610.00	$513.67	5
North Carolina	68	$776.95	$615.23	4
New York	58	$829.22	$528.07	4
Kansas	53	$798.26	$693.16	3
Colorado	48	$654.77	$489.18	3
District of Columbia	39	$949.10	$653.64	2
Missouri	38	$371.36	$327.84	2
Virginia	36	$568.09	$465.64	2
Louisiana	33	$837.99	$662.23	2
Ohio	31	$662.26	$546.09	2
New Jersey	30	$668.57	$507.64	2
Indiana	29	$877.46	$794.36	2
Minnesota	26	$1028.79	$849.81	2
Florida	23	$468.57	$344.48	2
Arizona	22	$746.97	$680.03	2
Nevada	16	$111.45	$81.35	1
Kentucky	16	$1086.79	$845.27	1
Illinois	15	$1012.35	$664.14	1
Pennsylvania	15	$897.74	$675.76	1
South Carolina	14	$643.78	$545.25	1
Wisconsin	13	$645.42	$584.04	1
Washington	12	$782.92	$549.92	1
Alabama	12	$563.62	$508.21	1
Massachusetts	11	$1123.22	$828.22	1

Related codes

22614Fusion of additional segment of spine$284.08
22612Fusion of spine in lower back$1477.10
22633Fusion of spine in lower back$1195.61
22634Fusion of additional segment of spine$335.52
22600Fusion of spine in neck by posterior approach$850.43
22630Fusion of lower spine bone and partial removal of spine bone or disc t$1109.53

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.