For a study, the researchers investigated the differences in Medicare reimbursement for 1-3 level lumbar decompression procedures performed at a tertiary referral center versus an Orthopedic Specialty Hospital (OSH). Patients who underwent a primary 1-3 level lumbar decompression were taken under consideration. Reimbursement information for a tertiary referral center and an OSH were compiled through the Centers for Medicare and Medicaid Services. Total episodes of care, facility, and non-facility payments were more significant at the tertiary referral center than the OSH, as were OR time for 1-3 level procedures, procedure time of all pooled levels, and LOS for 1 and 2 level procedures. The 3-level approach was independently related to increased OR time, procedure time, and LOS. Age and 2-level methods were also associated with higher LOS. Procedure at the OSH was correlated with less OR time and LOS. Charlson Comorbidity Index was a negative predictor of decompression performed in the OSH setting. Significant financial savings to health systems can be expected when performing lumbar decompression surgery at a specialty hospital instead of a tertiary referral center. Patients who were appropriate candidates for surgery in an OSH could expect faster perioperative times and shorter LOS.