CPT 63047 · professional fee

Lam facetec & foramot lumbar (CPT 63047): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 63047, from their published in-network rate files.

Orthopedic surgerySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$1,796

P10 to P90: $1,133 to $3,218

vs Medicare

168%

non-facility rate $1,065.49

Payer spread

1.32×

UHC $1,939 vs Aetna $1,464

State spread

3.8×

AK $4,926 to CA $1,313

5,049 sampled providers6,130 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

UnitedHealthcare has the highest median for CPT 63047 in the files analyzed, at $1,939, 32% above Aetna ($1,464), the lowest of the 4 payers shown.

The state spread is 3.8×: Alaska has the highest median at $4,926 and California the lowest at $1,313, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 168% of the Medicare non-facility rate ($1,065.49), which ranks 81st of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Blue Cross Blue Shield (interquartile range $893) and widest within UnitedHealthcare ($1,122).

This is a top-17 code for orthopedic surgery by Medicare allowed dollars, so it carries real revenue weight for that specialty.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
UnitedHealthcare	$1,939	$1,467	$2,590	+8%	1	4,263	182% of Medicare
Blue Cross Blue Shield	$1,921	$1,446	$2,339	+7%	2	3,920	180% of Medicare
Cigna	$1,832	$1,475	$2,427	+2%	3	4,048	172% of Medicare
Aetna	$1,464	$1,136	$1,874	-18%	4	2,805	137% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($1,065.49)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$4,926	+174%	Aetna	BCBS	65
2	Wyoming	$2,707	+51%	BCBS	UHC	65
3	Wisconsin	$2,437	+36%	BCBS	Aetna	97
4	Connecticut	$2,431	+35%	UHC	Aetna	114
5	South Dakota	$2,427	+35%	UHC	BCBS	97
6	Iowa	$2,351	+31%	Cigna	Aetna	104
7	Washington	$2,346	+31%	UHC	Aetna	101
8	District of Columbia	$2,337	+30%	UHC	BCBS	35
9	Nebraska	$2,267	+26%	Cigna	BCBS	95
10	New Jersey	$2,238	+25%	Cigna	BCBS	95
11	Mississippi	$2,217	+23%	Aetna	Cigna	112
12	Vermont	$2,191	+22%	UHC	Cigna	35
12	Massachusetts	$2,191	+22%	UHC	Aetna	111
14	Oregon	$2,188	+22%	UHC	Aetna	92
15	North Dakota	$2,187	+22%	BCBS	Aetna	46
16	Georgia	$1,998	+11%	UHC	BCBS	124
17	New York	$1,961	+9%	Cigna	Aetna	110
18	Minnesota	$1,952	+9%	UHC	Aetna	102
19	Tennessee	$1,950	+9%	Aetna	Cigna	115
20	North Carolina	$1,939	+8%	Cigna	Aetna	128
21	Illinois	$1,926	+7%	UHC	Aetna	103
22	Rhode Island	$1,893	+5%	UHC	Aetna	98
23	Idaho	$1,877	+5%	Aetna	UHC	120
24	Maryland	$1,827	+2%	Cigna	BCBS	105
25	Colorado	$1,797	+0%	UHC	Aetna	104
26	Montana	$1,767	-2%	UHC	Cigna	79
27	New Hampshire	$1,764	-2%	Cigna	Aetna	118
28	Utah	$1,751	-3%	BCBS	Cigna	97
29	Kansas	$1,744	-3%	Cigna	Aetna	107
30	Arkansas	$1,741	-3%	Cigna	Aetna	119
31	Alabama	$1,698	-5%	BCBS	Cigna	118
32	South Carolina	$1,695	-6%	UHC	Aetna	106
33	Delaware	$1,684	-6%	Cigna	UHC	59
34	Louisiana	$1,679	-7%	BCBS	UHC	103
35	Pennsylvania	$1,676	-7%	UHC	Aetna	103
36	New Mexico	$1,659	-8%	UHC	BCBS	104
37	West Virginia	$1,625	-10%	UHC	Aetna	88
38	Virginia	$1,594	-11%	UHC	BCBS	105
39	Ohio	$1,568	-13%	UHC	Aetna	110
40	Arizona	$1,561	-13%	UHC	Aetna	99
41	Missouri	$1,539	-14%	BCBS	Aetna	112
42	Nevada	$1,531	-15%	BCBS	Aetna	109
43	Maine	$1,528	-15%	UHC	Aetna	93
44	Kentucky	$1,516	-16%	UHC	Aetna	124
45	Indiana	$1,497	-17%	UHC	Aetna	115
46	Michigan	$1,481	-18%	Aetna	UHC	102
47	Florida	$1,411	-21%	BCBS	Aetna	108
48	Hawaii	$1,364	-24%	BCBS	Cigna	68
49	Oklahoma	$1,363	-24%	Cigna	Aetna	100
50	Texas	$1,354	-25%	UHC	Aetna	121
51	California	$1,313	-27%	UHC	Aetna	109

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 63047?

In the files we analyzed, UnitedHealthcare, at a median of $1,939 across 4,263 sampled providers. Aetna is lowest at $1,464, 32% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 168% of the 2026 Medicare non-facility rate of $1,065.49.

Which state has the highest median for CPT 63047?

Alaska has the highest median at $4,926; California has the lowest at $1,313.

Is this the surgeon, physician or facility payment?

These are professional (physician) fees only. Facility, device and implant payments are priced separately and are not included.

How current is this data?

It is the August 2026 snapshot of each payer's in-network rate file. Sources and filters are listed in the methodology below.

Methodology

How these numbers are calculated

Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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