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CPT code 63043: Cervical laminotomy, additional interspace2026 Medicare rate & RVUs

Reports reexploration with nerve-root decompression at an additional cervical interspace after prior surgery, when performed with the required primary procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities67 Medicare services in 2024

Medicare rate · 63043

Cervical laminotomy, additional interspace

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
ZZZ

National rate · 2026

—

Not priced in the facility setting.

See every locality for 63043 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 63043 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 63043 covers

A spine surgeon reports 63043 when revisiting an additional cervical interspace during reoperation to relieve pressure on nerve roots. Depending on the anatomy and operative findings, the work may include removing a limited amount of bone, enlarging the nerve-root opening, or addressing recurrent disc material. It is used for a cervical level beyond the one represented by the primary reexploration code, such as in a patient with recurrent symptoms after earlier cervical surgery.

This is an add-on code, not a standalone service: report it with the applicable primary procedure, commonly 63040 for a single cervical reexploration interspace. Medicare assigns status C, meaning the national Physician Fee Schedule publishes no payment and the Medicare Administrative Contractor prices the claim. Payment is within the primary procedure’s global period. For a bilateral procedure, modifier 50 is paid at 150%. Report the additional cervical interspace or interspaces treated.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 63043 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

63043 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

63043 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
63043 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 63043 rate is calculated

Each of 63043’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 63043

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 63043

The CMS indicators that decide how 63043 is paid alongside other services.

CMS payment indicators · 63043

Cervical laminotomy, additional interspace

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

63043 without 50 · national facility

$0.00

Cervical laminotomy, additional interspace

63043-50 · Bilateral: 150%

$0.00

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

63043 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 63043

    Cervical laminotomy, additional interspace0 wRVU

    Not priced

  • 63040

    Cervical laminotomy, single cervical segment19.8 wRVU

    Not priced

  • 63035

    Nerve-root decompression, each additional interspace3.76 wRVU

    Not priced

  • 63044

    Lumbar re-exploration, each additional interspace0 wRVU

    Not priced

How to choose

63040Cervical laminotomySingle cervical segment
63040 represents the primary single cervical interspace reexploration; 63043 represents each additional cervical interspace treated in the same reexploration.
63035Nerve-root decompressionEach additional interspace
63035 is used for an additional interspace in the applicable nerve-root decompression code family; 63043 is for an additional cervical interspace during reexploration.
63044Lumbar re-explorationEach additional interspace
63044 is the additional-interspace reexploration code for the lumbar region. Use 63043 for the cervical region.

Codes related to 63043

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 63043
CodeHow it relatesNational office range
Primary code
63040Cervical laminotomy, single cervical segmentPrimary code for a single cervical interspace reexploration.No office rate
Same family
63044Lumbar re-exploration, each additional interspaceAdditional lumbar interspace reexploration code.No office rate
63042Lumbar decompression, single-level re-explorationSingle-interspace lumbar reexploration counterpart.No office rate
Used instead
63035Nerve-root decompression, each additional interspaceAdditional-interspace code for nerve-root decompression outside the reexploration code family.No office rate

63043 billing questions

When is 63043 used instead of 63040?

63040 represents the single cervical interspace for reexploration. Use 63043 for each additional cervical interspace treated during that reexploration.

Can 63043 be reported by itself?

No. It is an add-on code and must be reported with a primary procedure, commonly 63040 for cervical reexploration.

How many units should be reported?

Report the additional cervical interspace or interspaces treated. The primary reexploration interspace is represented by the primary code, not an additional unit of 63043.

How does Medicare price 63043?

Its Physician Fee Schedule status is C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.

How is a bilateral procedure reported?

For a bilateral procedure, modifier 50 is paid at 150%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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