CPT code 63052: Spinal decompression, single lumbar segment2026 Medicare rate & RVUs in Missouri
Reports additional lumbar nerve or spinal canal decompression performed at one segment during posterior interbody fusion for stenosis or related compression.
CMS doesn’t publish an office rate for 63052 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 63052 covers
This add-on describes a surgeon’s decompression of the lumbar canal, lateral recess, or nerve roots at one segment while performing posterior interbody fusion. The work may involve removing bone or other compressive tissue to relieve stenosis or nerve compression. It is used when decompression goes beyond the work needed to access and prepare the disc space for fusion, rather than for routine fusion exposure alone.
Report 63052 with the applicable primary posterior interbody arthrodesis service, such as 22630 or 22633. The operative report should identify the lumbar segment, the compression being treated, and the additional decompression performed. Medicare treats 63052 as an add-on: it is billed only with a primary procedure and paid within that procedure’s global period. For an additional decompressed segment, consider the related add-on code 63053 when its requirements are met.
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 63052 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $225.93 |
| Metropolitan St. Louis, MO | Unavailable | $227.66 |
| Rest of Missouri | Unavailable | $222.22 |
How the 63052 rate is calculated
Each of 63052’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 · 63052
RVUs × geographic indexes × conversion factor
Work4.14
4.14 RVUs× 1.000 GPCI
Practice expense1.39
1.39 RVUs× 1.000 GPCI
Malpractice1.35
1.35 RVUs× 1.000 GPCI
Adjusted RVUs
6.8800
Conversion factor
$33.4009
Medicare rate
$229.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63052
The CMS indicators that decide how 63052 is paid alongside other services.
CMS payment indicators · 63052
Spinal decompression, single lumbar segment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
63052 without 80 · national facility
$229.80
Spinal decompression, single lumbar segment
63052-80 · Assistant: 16%
$36.77
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
63052 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 63047Lumbar decompressionSingle lumbar segment
- Use 63052 for additional decompression performed during posterior interbody fusion. 63047 describes lumbar decompression outside that fusion-specific context.
- 63053Lumbar decompressionAdditional fusion segment
- 63052 covers one lumbar segment; 63053 is the add-on for each additional decompressed segment during posterior interbody arthrodesis.
- 22630Lumbar fusionSingle lumbar interspace
- 22630 reports the posterior interbody fusion itself. 63052 reports qualifying additional decompression at one segment and is not a stand-alone fusion code.
63052 billing questions
Can 63052 be billed by itself?
No. It is an add-on and must be reported with a qualifying primary posterior interbody arthrodesis procedure.
What distinguishes 63052 from 63047?
63052 is for additional decompression performed during posterior interbody fusion. 63047 describes lumbar decompression outside that specific fusion context.
Does routine work to prepare the disc space support 63052?
No. The record should support additional decompression for neural or canal compression beyond the work needed to access and prepare the space for fusion.
When is 63053 used with 63052?
63053 is the related add-on for decompression at each additional segment. Document the separate level and decompressive work.
What documentation supports reporting 63052?
Document the lumbar segment, the source of compression, and the decompression performed in addition to the posterior interbody fusion work.
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.
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