Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without — what U.S. hospitals charge

MS-DRG 428 · Inpatient stay · 19 U.S. hospitals publish a price

Cheapest quarter

under $152,721

Typical charge

$219,818

Dearest quarter

over $244,629

Actually paid

$48,808

The middle U.S. hospital bills $219,818 for Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without. The dearest hospitals charge about 2.7x what the cheapest do for the same coded work. Medicare actually paid about $48,808 per case.

These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.

Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without cost by state

The middle charge in each state where at least three hospitals publish a price, cheapest first.

State	Hospitals	Typical charge	Range
Louisiana	3	$150,165	$142,736 – $219,818
North Carolina	4	$237,315	$162,326 – $295,797

Where Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without is charged least

Hospitals that performed it at least eleven times, so a single case cannot set the figure.

Hospital	Charged	Actually paid
Fresno Surgical Hospital Fresno, CA	$88,077	$50,221
Mcbride Orthopedic Hospital Oklahoma City, OK	$122,313	$36,570
Baptist Memorial Hospital Memphis, TN	$136,547	$40,949
Specialists Hospital Shreveport Shreveport, LA	$142,736	$34,547
The Spine Hospital Of Louisiana Baton Rouge, LA	$150,165	$34,631
Mayo Clinic Jacksonville, FL	$155,277	$55,198
Firsthealth Moore Regional Hospital Pinehurst, NC	$162,326	$38,425
Oklahoma Spine Hospital Oklahoma City, OK	$167,820	$37,526
Baptist Hospital Pensacola, FL	$209,686	$41,587
Avala Covington, LA	$219,818	$34,087
Carolinas Medical Center/Behav Health Charlotte, NC	$235,186	$58,837
Medstar Georgetown University Hospital Washington, DC	$236,567	$72,823

Where it is charged most

Hospitals that performed it at least eleven times, so a single case cannot set the figure.

Hospital	Charged	Actually paid
Medical City Plano Plano, TX	$990,845	$63,614
Scripps Green Hospital La Jolla, CA	$537,070	$90,675
Huntsville Hospital Huntsville, AL	$322,864	$36,800
Wakemed, Raleigh Campus Raleigh, NC	$295,797	$44,930
Nebraska Spine Hospital, Llc Omaha, NE	$247,004	$38,841
Centura Health-Penrose St Francis Health Services Colorado Springs, CO	$242,253	$58,321
Duke University Hospital Durham, NC	$239,445	$58,771
Medstar Georgetown University Hospital Washington, DC	$236,567	$72,823
Carolinas Medical Center/Behav Health Charlotte, NC	$235,186	$58,837
Avala Covington, LA	$219,818	$34,087
Baptist Hospital Pensacola, FL	$209,686	$41,587
Oklahoma Spine Hospital Oklahoma City, OK	$167,820	$37,526

Questions people ask

What do U.S. hospitals charge for Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without?

Across 19 U.S. hospitals, the middle charge for Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without is $219,818. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $152,721 and the dearest quarter over $244,629.

Why do hospitals charge such different amounts for the same procedure?

Because a hospital charge is a list price it sets itself, not a regulated rate. For Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without, the hospitals in the dearest tenth charge about 2.7x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.

Is that what I would actually pay?

No. $48,808 is roughly what Medicare actually paid per case, against an average charge of $241,737. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.

What this code covers

CMS records this work as MS-DRG 428: “MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/”. A DRG covers a whole inpatient stay rather than a single item, so the charge includes the room, the procedure and the care around it. Codes that mention complications carry a different, usually higher price.

Related procedures

Level 5 Musculoskeletal Procedures typically $62,465
Level 4 Musculoskeletal Procedures typically $39,867
Level 3 Musculoskeletal Procedures typically $20,376
Level 2 Musculoskeletal Procedures typically $11,229
Level 6 Musculoskeletal Procedures typically $83,029
Hip or Thigh Bone Surgery (with complications) typically $83,324
Hip or Knee Replacement (without major complications) typically $79,947
Back Problems (without major complications) typically $39,073

Before you are billed

Ask for a written good-faith estimate — you are entitled to one if you are uninsured or paying yourself.
Check the hospital's machine-readable price file; every U.S. hospital must publish one.
If you are insured, ask whether every provider involved is in network — the surprise usually comes from the ones you never met.

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