Price Checker / CPT 63042
How much does Laminotomy Single Lumbar cost?
CPT 63042 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 30x the fair price — among the most extreme markups. Dispute this.
Fair price
$1,850–$3,650
What this should cost
With insurance
~$6,850
Typical out-of-pocket
Overcharged if over
$4,550
Push back above this
The average hospital charge of $82,288 is $79,538 over the fair price (about 30x the fair rate).
What hospitals charge for Laminotomy Single Lumbar
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Tanner Medical Center/Villa Rica Villa Rica, GA | $152,739 | — | 11545% |
| Tattnall Hospital , GA | $60,000 | — | 778% |
| North Carolina Specialty Hospital DURHAM, NC | $34,124 | — | 465% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Laminotomy Single Lumbar
CPT code 63042 refers to laminotomy single lumbar (billing description: "Laminotomy single lumbar"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $1,220 in a facility (hospital or surgery center) and $1,220 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.