What is the standard insurance baseline for CPT 63052?

The standard insurance baseline reimbursement rate is $229.04. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Partial Removal of Bone of Single Segment of Spine in Lower Back with Release of Spinal Cord and or Nerves During Fusion of Spine in Lower Back

CPT 63052Medical Service

Partial Removal of Bone of Single Segment of Spine in Lower Back with Release of Spinal Cord and or Nerves During Fusion of Spine in Lower Back

Q: What do doctors typically charge for Partial Removal of Bone of Single Segment of Spine in Lower Back with Release of Spinal Cord and or Nerves During Fusion of Spine in Lower Back?

The nationwide median physician charge for Partial Removal of Bone of Single Segment of Spine in Lower Back with Release of Spinal Cord and or Nerves During Fusion of Spine in Lower Back (CPT 63052) is $735.00. Doctor billed charges vary based on geographic region, setting, and overhead.

Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back. Clinical pricing breakdown and utilization metrics across 1,335 practicing doctors nationwide.

$735.00

Peer Median Charge

Gross billed rate

$229.04

Standard Baseline

Customary allowable

3.2x

National Markup

Charge vs baseline

1,335

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $735.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $229.04 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 63052 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"