Price AtlasInteractive atlas · All states · techysurgeon.comWhat the whole lumbar fusion with cage (TLIF/PLIF) costs
Low-back fusion through the back with a spacer (cage) in the disc space: combined (22633) or interbody only (22630). Screws (22840), cage (22853) and bone graft (20930/20936) are billed as add-ons. Every bill that usually comes with it, who sends it, and where each number comes from.
Price it for your ZIP, hospital or insurerRates by insurer
Partial estimate. Add-on codes often billed with it (22634, 22632, 22840, 22853) are not included. The totals below run low.
Medicare, national amounts, 2026
| Bill | Surgery center | Hospital outpatient | Hospital stay |
|---|---|---|---|
| Facility | $20,841 | $27,722 | $24,085 |
| Surgeon | $1,700 | $1,700 | $1,700 |
| Assistant | $272 | $272 | $272 |
| Anesthesia | $437 | $437 | $437 |
| Before surgery (typical) | $249 | $249 | $249 |
| After surgery (typical) | $40 | $40 | $40 |
| Total | $23,540 | $30,420 | $26,783 |
National Medicare amounts (payment-area and wage adjustments at 1.0). Facility: OPPS Addendum B, July 2026 (national unadjusted rate); local = rate × (0.6 × wage index + 0.4); ASC Addendum AA, July 2026 (national rate); local = rate × (0.5 × wage index + 0.5); device-intensive (J8) codes keep the device portion unadjusted; FY 2027 IPPS final rule CMS-1849-F as corrected by CMS-1849-CN (91 FR 61328), Table 5 (effective Oct 1, 2026); standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons. Surgeon: CMS Physician Fee Schedule CY2026 (RVU26D). Anesthesia: CMS base units × the CY2026 anesthesia conversion factor, with an assumed case time. An educational estimate, not a quote.
Line by line (surgery center)
- Surgery center facility fee: $20,841. Billed by The surgery center. CMS ASC Addendum AA, July 2026: national rate $20,841.42
- Surgeon, CPT 22633: $1,700. Billed by The surgeon's group. CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026 release), facility rate, PFS locality national (GPCI 1.0)
- Assistant surgeon (modifier 80): $272. Billed by The assistant surgeon. Medicare Claims Processing Manual, Ch. 12, §20.4.3: assistant-at-surgery (modifiers 80/81/82) = 16% of the surgeon's fee schedule amount; a PA, NP or CNS assisting (modifier AS) = 85% of that, 13.6%. Indicator from the RVU26D ASST SURG column (0 = only with documented medical necessity, 1 = not paid, 2 = paid).
- Anesthesia, ASA code 00630: $437. Billed by The anesthesia group. CMS anesthesia base units (CY2022 file, unchanged for CY2026) + CY2026 anesthesia conversion factor $20.49754 for the nation (ANES2026, RVU26D). Code mapping is ours, from the ASA code descriptors.
- Consultation visit (new patient): $177. Billed by The surgeon's group. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 99204
- X-rays before surgery: $40. Billed by Office or imaging center. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 72100
- Blood count (CBC): $8. Billed by The lab. CMS Clinical Laboratory Fee Schedule CY2026 Q4 (26CLABQ4), national limit
- Basic metabolic panel: $8. Billed by The lab. CMS Clinical Laboratory Fee Schedule CY2026 Q4 (26CLABQ4), national limit
- Pre-op ECG: $15. Billed by Office or hospital. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 93000
- Follow-up X-ray: $40. Billed by Office or imaging center. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 72100
Questions
How much does a lumbar fusion with cage (TLIF/PLIF) cost in total, with every bill?
At national Medicare rates for 2026, the whole lumbar fusion with cage (TLIF/PLIF) comes to about $23,540 in a surgery center and about $30,420 in a hospital outpatient, counting the facility, the surgeon, anesthesia and typical care before and after. Commercial plans usually pay more; local rates differ by area.
Why do I get separate bills for a lumbar fusion with cage (TLIF/PLIF)?
The surgery center bills for the facility; the surgeon's group bills for the operation (Surgeon, CPT 22633, about $1,700 from Medicare nationally); the anesthesia group bills by base units plus time (about $437 at our default time); labs, imaging, pathology and therapy each come from their own provider.
What does the surgeon's fee include?
90-day global: the fee covers the operation plus the visit the day before and routine follow-up visits for 90 days.