Lower back (lumbar) spinal fusion Cost by Hospital

Lower back (lumbar) spinal fusion is a surgical procedure. Prices are from 800 US hospitals across 47 states, from their machine-readable files.

Price comparison (median)

Lowest cash prices

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated October 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Lower back (lumbar) spinal fusion

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $74,742; Medicare pays $1,511.

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

Prices by city

Prices by state

Doctors who perform this

Clinicians who reported the most Medicare volume for this service. This reflects Original Medicare activity only and is a volume signal, not a quality ranking.

Commonly billed under: MS-DRG 459, MS-DRG 460.

Does Medicare cover Lower back (lumbar) spinal fusion?

Yes — Medicare generally covers Lower back (lumbar) spinal fusion. It is typically an inpatient service, so Medicare Part A (hospital insurance) pays the hospital a bundled rate — Medicare’s benchmark payment is about $1,511. Your own cost is mainly the Part A hospital deductible for the benefit period (a flat amount, not a percentage), plus any physician (Part B) charges. A Medicare Advantage or Medigap plan can change what you owe.

General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.

About these prices

Based on prices published by 800 US hospitals across 47 states, the typical (median) cash price is $74,742, versus a chargemaster (list) price around $185,388, a median insurer-negotiated rate of $47,726, a Medicare rate of about $1,511. Most cash prices fall between $36,985 and $150,080 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

• Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
• Compare several nearby hospitals; prices for the same service can differ severalfold.
• Request a written estimate and the billing code (CPT/DRG) before scheduling.
• Use the Medicare benchmark above to judge whether a quote is reasonable.
• If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

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