Lumbar Discectomy Cost in District of Columbia
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$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
District of Columbia Medicare physician rate (2026)
+11.5% vs nationalSingle statewide locality.
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.
Your ZIP in District of Columbia
Enter a ZIP code to see how the DC locality applies to your address, whether you are in the District itself, Bethesda or Silver Spring on the Maryland side, or Arlington and Alexandria in Virginia.
What lumbar discectomy costs at hospitals near you
Everything above is a national average. The hospital you pick in District of Columbia 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.
National vs District of Columbia
Where District of Columbia ranks for this CPT
Lumbar Discectomy and how District of Columbia is priced
The District of Columbia is unusual in the fee schedule: it forms its own high-cost locality that reaches beyond the city line to cover close-in Maryland and Virginia suburbs, including areas such as Montgomery and Prince George's counties and the Arlington and Alexandria side of the Potomac. Its geographic indices are among the highest in the country, reflecting the region's wages and office costs. As a result, DC-area Medicare-approved amounts run well above those in the rest of Maryland or Virginia, and the boundary of that locality can matter more than the state line. A patient in Bethesda is priced with Washington, not with Baltimore.
The Washington area is dense with hospitals, including multiple academic medical centers and large regional systems competing across the district and its suburbs. That density gives patients real choice within a short distance, which is rare in American health care. Federal employment also means an unusually well-insured population, so cash-pay and Medicare-rate comparisons are most useful for those outside employer coverage.
This procedure: 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 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.
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?
Other featured procedures in District of Columbia
Lumbar Discectomy in other states
Lumbar Discectomy in District of Columbia: questions
District of Columbia is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 63030 is $1,001.23 in an office and $1,001.23 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. District of Columbia uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $200 for the office physician line or $200 for the hospital physician line in District of Columbia. Medigap may cover that 20%. This is not the hospital facility fee.
No. $1,001.23 is only the physician's share. Adding Medicare's facility payment brings the total to about $8,312 in a hospital outpatient department, or about $4,594 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. District of Columbia ranks #47 of 51 states on the physician line (11% above the national office rate of $898.15).