Lumbar Discectomy Cost in Rhode Island
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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
Rhode Island Medicare physician rate (2026)
+0.7% 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 Rhode Island
Enter a ZIP code for your part of Rhode Island, whether Providence and Pawtucket, Warwick and Cranston, Newport, or the South County shore towns.
What lumbar discectomy costs at hospitals near you
Everything above is a national average. The hospital you pick in Rhode Island 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 Rhode Island
Where Rhode Island ranks for this CPT
Lumbar Discectomy and how Rhode Island is priced
Rhode Island, the smallest state, is unsurprisingly a single payment locality, with geographic adjustments above the national average in line with southern New England's cost structure. Providence and the shoreline towns publish identical Medicare-approved amounts, and no point in the state is more than an hour from its main hospitals. The compact geography makes locality subdivision pointless. Pricing here reads as a slightly discounted echo of neighboring Boston's market.
Providence dominates Rhode Island care, with the state's teaching hospitals and academic affiliation concentrated there, and consolidation has left a small number of systems running most beds. Many Rhode Islanders, particularly in the northeast corner, use Boston hospitals for complex or specialized procedures, accepting metro Boston pricing when they do. South County residents have fewer local options and often travel to Providence.
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 Rhode Island
Lumbar Discectomy in other states
Lumbar Discectomy in Rhode Island: questions
Rhode Island is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 63030 is $904.23 in an office and $904.23 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Rhode Island 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 $181 for the office physician line or $181 for the hospital physician line in Rhode Island. Medigap may cover that 20%. This is not the hospital facility fee.
No. $904.23 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. Rhode Island ranks #37 of 51 states on the physician line (within 2% of the national office rate of $898.15).