CPT63030

Lumbar Discectomy Cost in Maryland

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$8,312Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Maryland Medicare physician rate (2026)

+3.5% vs national

Average of 2 localities. Office range $896.09–$962.47.

Maryland (Hospital)
$929.28
Facility physician fee
Private plan est.
$1,208–$1,859
~130–200% of Medicare
Cash / self-pay est.
$743–$1,394
~80–150% of Medicare

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.

Surgery centre, total
$4,594
$898 physician + $3,696 facility
Physician fee alone
$898
Only 11% of the hospital total

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 Maryland

A ZIP lookup matters in Maryland because three different locality treatments are in play: check whether you fall in the Baltimore area, the DC suburbs like Bethesda and Silver Spring, or rest-of-state regions like Frederick, Hagerstown, and the Eastern Shore.

What lumbar discectomy costs at hospitals near you

Everything above is a national average. The hospital you pick in Maryland moves the bill more than anything else you control.

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Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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 Maryland

National office$898.15
National hospital (physician)$898.15
Maryland vs national3% above the national office rate of $898.15

Where Maryland ranks for this CPT

Rank (lowest physician fee first)#42 of 51
Lowest stateArkansas ($782.49)
Highest stateAlaska ($1,060.60)

CPT 63030 by Maryland locality

LocalityOffice
baltimore/surr. cntys$962.47
rest of maryland$896.09

PE GPCI ranges from 1.012 to 1.073 in Maryland. That index is why the same CPT is not one price statewide.

Lumbar Discectomy and how Maryland is priced

Maryland's Medicare physician pricing is split geographically: Baltimore and its surrounding counties form one locality, the rest of the state another, and, unusually, the Washington suburbs including Montgomery and Prince George's counties are priced inside the District of Columbia's high-cost locality rather than either Maryland one. That three-way carve means a Rockville procedure is approved at DC-area rates while an identical one in Frederick or Salisbury is not. Baltimore-area adjustments sit above rest-of-state levels but below the DC locality. Few states have their pricing shaped this much by a neighboring jurisdiction.

Maryland is also the only state with an all-payer rate-setting system for hospital services, so hospital-side billing works differently here than anywhere else in the country, though physician fees still follow the standard Medicare schedule. Baltimore's academic medical centers rank among the most prominent in the world and draw patients globally. The Eastern Shore and western Maryland are far more rural, with patients often traveling to Baltimore, Annapolis, or across state lines.

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?

Lumbar Discectomy in Maryland: questions

The 2026 Medicare physician office rate for CPT 63030 averages $929.28 across 2 Maryland localities, from $896.09 in REST OF MARYLAND to $962.47 in BALTIMORE/SURR. CNTYS. The hospital physician rate averages $929.28. Enter a ZIP for the exact locality.

Yes. CMS splits Maryland into 2 payment localities. For this CPT the office physician fee spans $66.38 from the lowest to highest locality. A ZIP lookup matters in Maryland because three different locality treatments are in play: check whether you fall in the Baltimore area, the DC suburbs like Bethesda and Silver Spring, or rest-of-state regions like Frederick, Hagerstown, and the Eastern Shore.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $186 for the office physician line or $186 for the hospital physician line in Maryland. Medigap may cover that 20%. This is not the hospital facility fee.

No. $929.28 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. Maryland ranks #42 of 51 states on the physician line (3% above the national office rate of $898.15).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.