CPT code 63056: Spinal decompression, lumbar, single segment2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 63056 in California.

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

What 63056 covers

A spine surgeon uses a transpedicular route through a lumbar vertebra to reach and decompress neural structures, such as when a herniated disc or another extradural lesion is compressing them. The code describes work at one lumbar segment. This is an operative service, typically performed in a hospital or other surgical facility by an orthopedic spine surgeon or neurosurgeon.

Report the code when the operative documentation supports both the transpedicular approach and decompression at a single lumbar segment. Identify the treated level, compressive pathology, and work performed; a routine lumbar laminotomy or decompression by a different approach is not this service. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 63056 pays more and less in California

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

29 of 29 payment localities

How the 63056 rate is calculated

Each of 63056’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.

Payment rules and modifiers for 63056

63056 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

63056 compared with similar codes

How to choose

63030Lumbar decompressionSingle interspace

Choose 63056 for a transpedicular approach to lumbar neural decompression at one segment. Code 63030 describes a laminotomy approach to lumbar nerve-root decompression.

63047Lumbar decompressionSingle lumbar segment

Code 63047 describes lumbar decompression using laminectomy, facetectomy, and foraminotomy. It is distinct from the transpedicular approach represented by 63056.

63055Spinal decompressionThoracic, single segment

The two codes share the transpedicular decompression approach, but 63055 is for a thoracic segment and 63056 is for a lumbar segment.

63057Spinal decompressionEach additional thoracic or lumbar segment

Code 63057 is for each additional qualifying segment; 63056 reports the primary lumbar segment.

Codes related to 63056

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

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