Lumbar Discectomy Cost
Lamot dcmprn nrv rt 1 lmbr
$8,312Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
National Medicare physician rate (2026)
What the whole procedure costs
The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.
Choosing a surgery centre over a hospital saves about $3,718 on the Medicare allowed amount for lumbar discectomy. Ask whether your procedure can be done at an ambulatory surgery centre.
Medicare pays the hospital a single comprehensive amount for this procedure, covering the facility's share of the encounter including implants and supplies. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Get the rate for your ZIP
CMS adjusts this CPT by locality. A five-digit ZIP is enough — no account, no insurance card.
What lumbar discectomy costs at hospitals near you
Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.
How CMS prices CPT 63030
Work is about 44% of the office total RVU; practice expense is about 42%. Localities with a high PE GPCI move this code more when practice expense is a large share.
Office vs hospital for this code
Office (non-facility) physician rate: $898.15. Hospital (facility) physician rate: $898.15.
Medicare patients typically owe 20% of the allowed amount after the Part B deductible — about $180 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.
Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.
What Is Lumbar Discectomy?
Lumbar discectomy removes the herniated portion of a spinal disc in the lower back that is pressing on a nerve root, relieving the leg pain, numbness, or weakness known as sciatica. Performed through a small incision, often with a microscope, it is one of the most common spine surgeries. The operation takes one to two hours under general anesthesia, and most patients go home the same day or after one night, with leg pain often improved immediately.
What Affects the Cost
- –Facility choice matters: this surgery is increasingly done at ambulatory surgery centers at far lower facility fees than hospitals.
- –Operating on more than one disc level adds an add-on code and increases surgeon and facility charges.
- –The pre-surgical MRI, specialist consultations, and any epidural steroid injections tried first are all part of the real episode cost.
- –Neuromonitoring during surgery, used by some surgeons, generates a separate and sometimes out-of-network professional bill.
- –Post-operative physical therapy, commonly prescribed after recovery, is billed per visit.
- –Reherniation occurs in a minority of patients and a revision surgery restarts the entire cost cycle.
How It Is Billed
CPT 63030 covers the surgeon's fee for removing herniated disc material at one lumbar level, with a 90-day global period for routine follow-up; each additional level is billed with add-on code 63035. Facility, anesthesia, and any neuromonitoring company bill separately, and the neuromonitoring claim is a known source of surprise out-of-network charges worth asking about by name. Imaging and physical therapy before and after the operation carry their own claims.
Insurance & Coverage Notes
Insurers cover discectomy for nerve compression confirmed on MRI, but nearly all commercial plans require prior authorization with documented conservative care, typically six weeks or more of therapy, medication, or injections, unless you have progressive weakness or other urgent findings. Medicare covers it without the conservative-care gate but with standard Part B coinsurance for outpatient surgery. Appeal rights matter here: spine surgery denials for incomplete documentation are common and frequently overturned when records are supplied.
Questions to Ask Before Booking
- 1.Has prior authorization been approved, including my documented weeks of conservative treatment?
- 2.Can my surgery be done at an ambulatory surgery center, and what is the facility price difference?
- 3.Will you use intraoperative neuromonitoring, and is that company in my network?
- 4.How many disc levels will you operate on, and how does each level change the cost?
- 5.What is your reherniation rate, and what would a revision surgery cost me?
Lumbar Discectomy (CPT 63030): questions
The 2026 national Medicare physician rate for CPT 63030 is $898.15 in an office and $898.15 in a hospital. Enter a ZIP code to apply the geographic adjustment for your locality.
For CPT 63030 the office and hospital physician rates are essentially the same ($898.15). The hospital will still usually add a separate facility fee that this page does not show.
Lumbar discectomy removes the herniated portion of a spinal disc in the lower back that is pressing on a nerve root, relieving the leg pain, numbness, or weakness known as sciatica. Performed through a small incision, often with a microscope, it is one of the most common spine surgeries. The operation takes one to two hours under general anesthesia, and most patients go home the same day or after one night, with leg pain often improved immediately. CMS bills it as “Lamot dcmprn nrv rt 1 lmbr.”
Not on its own. $898.15 is the physician allowed amount. Medicare also pays the facility, which takes the total to about $8,312 in a hospital outpatient department or about $4,594 at an ambulatory surgery centre. Anesthesia, pathology and imaging interpretation billed under other codes are separate again. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.
For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.