CPT code 63078: Thoracic disk surgery, each additional interspace2026 Medicare rate & RVUs in Puerto Rico
Reports anterior thoracic disk removal with spinal cord or nerve root decompression at each additional interspace beyond the primary thoracic level.
In Puerto Rico, Medicare pays $188.46 for 63078 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 63078 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 63078 covers
This add-on represents treatment of an additional thoracic disk interspace through an anterior approach, removing disk material and decompressing the spinal cord or nerve root; associated bone spurs may also be removed. It is typically performed by a spine surgeon or neurosurgeon in an operating room for thoracic disk disease causing cord or nerve root compression. The code describes another interspace treated, not another piece of disk removed from the same space.
Report 63078 only with the primary thoracic interspace procedure, 63077. The operative report should identify the thoracic interspaces treated and document the anterior disk removal and neural decompression at each additional space. CMS classifies 63078 as an add-on code: it is billed with a primary procedure and paid within that procedure’s global period.
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.
How Puerto Rico compares for 63078
Across 109 of 109 payment localities, the facility rate for 63078 runs from $156.40 in Wisconsin to $258.17 in Miami, FL. Puerto Rico pays $188.46. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$188.46
- Los Angeles, CA · California$185.02−$3.44
- Washington, DC area · District of Columbia$206.17+$17.71
- Miami, FL · Florida$258.17+$69.71
- Chicago, IL · Illinois$247.18+$58.72
- Manhattan, NY · New York$227.65+$39.19
- Alaska · Alaska$224.64+$36.18
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $164.76 |
| ArkansasArkansas | — | $161.90 |
| ArizonaArizona | — | $181.16 |
| Bakersfield, CACalifornia | — | $176.97 |
| Chico, CACalifornia | — | $173.51 |
| El Centro, CACalifornia | — | $173.73 |
| Fresno, CACalifornia | — | $173.51 |
| Hanford, CACalifornia | — | $173.51 |
| Madera, CACalifornia | — | $173.51 |
| Merced, CACalifornia | — | $173.51 |
| Modesto, CACalifornia | — | $173.51 |
| Napa, CACalifornia | — | $185.49 |
| Oxnard, CACalifornia | — | $181.77 |
| Redding, CACalifornia | — | $173.51 |
| Rest of CaliforniaCalifornia | — | $173.51 |
| Riverside, CACalifornia | — | $187.70 |
| Sacramento, CACalifornia | — | $178.05 |
| Salinas, CACalifornia | — | $177.36 |
| San Diego, CACalifornia | — | $178.91 |
| Marin County, CACalifornia | — | $190.17 |
| San Francisco, CACalifornia | — | $188.66 |
| San Benito County, CACalifornia | — | $196.39 |
| Santa Clara County, CACalifornia | — | $190.22 |
| San Luis Obispo, CACalifornia | — | $175.12 |
| Santa Cruz, CACalifornia | — | $178.39 |
| Santa Maria, CACalifornia | — | $177.31 |
| Santa Rosa, CACalifornia | — | $179.84 |
| Stockton, CACalifornia | — | $173.51 |
| Vallejo, CACalifornia | — | $183.31 |
| Visalia, CACalifornia | — | $173.51 |
| Yuba City, CACalifornia | — | $173.51 |
| ColoradoColorado | — | $182.66 |
| ConnecticutConnecticut | — | $203.06 |
| DelawareDelaware | — | $184.31 |
| Fort Lauderdale, FLFlorida | — | $225.10 |
| Rest of FloridaFlorida | — | $209.41 |
| Atlanta, GAGeorgia | — | $198.56 |
| Rest of GeorgiaGeorgia | — | $193.20 |
| Hawaii, Guam, HIHawaii | — | $175.14 |
| IowaIowa | — | $158.75 |
| IdahoIdaho | — | $162.31 |
| East St. Louis, ILIllinois | — | $230.77 |
| Rest of IllinoisIllinois | — | $210.47 |
| Suburban Chicago, ILIllinois | — | $224.77 |
| IndianaIndiana | — | $163.15 |
| KansasKansas | — | $163.09 |
| KentuckyKentucky | — | $180.79 |
| New Orleans, LALouisiana | — | $192.55 |
| Rest of LouisianaLouisiana | — | $182.55 |
| Metropolitan Boston, MAMassachusetts | — | $195.47 |
| Rest of MassachusettsMassachusetts | — | $183.39 |
| Baltimore area, MDMaryland | — | $203.68 |
| Rest of MarylandMaryland | — | $186.59 |
| Rest of MaineMaine | — | $168.93 |
| Southern Maine, MEMaine | — | $171.99 |
| Detroit, MIMichigan | — | $217.88 |
| Rest of MichiganMichigan | — | $191.19 |
| MinnesotaMinnesota | — | $158.53 |
| Metropolitan Kansas City, MOMissouri | — | $185.41 |
| Metropolitan St. Louis, MOMissouri | — | $187.01 |
| Rest of MissouriMissouri | — | $182.40 |
| MississippiMississippi | — | $171.92 |
| MontanaMontana | — | $188.63 |
| North CarolinaNorth Carolina | — | $170.17 |
| North DakotaNorth Dakota | — | $162.33 |
| NebraskaNebraska | — | $158.20 |
| New HampshireNew Hampshire | — | $184.70 |
| Northern New JerseyNew Jersey | — | $204.45 |
| Rest of New JerseyNew Jersey | — | $200.74 |
| New MexicoNew Mexico | — | $194.54 |
| NevadaNevada | — | $181.33 |
| NYC suburbs and Long Island, NYNew York | — | $240.70 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $206.41 |
| Queens, NYNew York | — | $222.00 |
| Rest of New YorkNew York | — | $173.65 |
| OhioOhio | — | $185.82 |
| OklahomaOklahoma | — | $174.81 |
| Portland, OROregon | — | $183.21 |
| Rest of OregonOregon | — | $175.37 |
| Metropolitan Philadelphia, PAPennsylvania | — | $200.75 |
| Rest of PennsylvaniaPennsylvania | — | $183.20 |
| Rhode IslandRhode Island | — | $187.18 |
| South CarolinaSouth Carolina | — | $179.21 |
| South DakotaSouth Dakota | — | $159.22 |
| TennesseeTennessee | — | $164.74 |
| Austin, TXTexas | — | $186.03 |
| Beaumont, TXTexas | — | $182.19 |
| Brazoria, TXTexas | — | $179.46 |
| Dallas, TXTexas | — | $183.22 |
| Fort Worth, TXTexas | — | $183.42 |
| Galveston, TXTexas | — | $181.67 |
| Houston, TXTexas | — | $206.01 |
| Rest of TexasTexas | — | $182.50 |
| UtahUtah | — | $181.94 |
| VirginiaVirginia | — | $175.02 |
| Virgin Islands, VIUnited States Virgin Islands | — | $188.46 |
| VermontVermont | — | $166.40 |
| Rest of WashingtonWashington | — | $181.47 |
| King County, WAWashington | — | $194.42 |
| WisconsinWisconsin | — | $156.40 |
| West VirginiaWest Virginia | — | $202.96 |
| WyomingWyoming | — | $177.17 |
63078 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 63078 rate is calculated
Each of 63078’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 · 63078
RVUs × geographic indexes × conversion factor
Work3.20
3.20 RVUs× 1.000 GPCI
Practice expense1.12
1.12 RVUs× 1.000 GPCI
Malpractice1.33
1.33 RVUs× 1.000 GPCI
Adjusted RVUs
5.6500
Conversion factor
$33.4009
Medicare rate
$188.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,020
- Code
- 63078
- Physician work
- 3.20
- Practice expense
- 1.12
- Malpractice
- 1.33
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.20 | × 1.000 | 3.2000 |
| Practice expense | 1.12 | × 1.011 | 1.1323 |
| Malpractice | 1.33 | × 0.985 | 1.3101 |
| Total RVUs | 5.6424 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Puerto Rico$188.46
Facility: (3.2 × 1 + 1.12 × 1.011 + 1.33 × 0.985) × $33.4009 = $188.46
Payment rules and modifiers for 63078
The CMS indicators that decide how 63078 is paid alongside other services.
CMS payment indicators · 63078
Thoracic disk surgery, each additional interspace
| 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
63078 without 80 · national facility
$188.72
Thoracic disk surgery, each additional interspace
63078-80 · Assistant: 16%
$30.20
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
How 63078 has changed in Puerto Rico
63078 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $188.46 | RVU26D |
| 2026-07-01 | Not available in this setting | $188.46 | RVU26C |
| 2026-04-01 | Not available in this setting | $188.46 | RVU26B |
| 2026-01-01 | Not available in this setting | $188.46 | RVU26A |
| 2025-10-01 | Not available in this setting | $201.41 | RVU25D |
| 2025-07-01 | Not available in this setting | $201.41 | RVU25C |
| 2025-04-01 | Not available in this setting | $201.41 | RVU25B |
| 2025-01-01 | Not available in this setting | $201.41 | RVU25A |
| 2024-10-01 | Not available in this setting | $206.27 | RVU24D |
| 2024-07-01 | Not available in this setting | $206.27 | RVU24C |
| 2024-04-01 | Not available in this setting | $206.27 | RVU24B |
| 2024-03-09 | Not available in this setting | $206.27 | RVU24AR |
| 2024-01-01 | Not available in this setting | $202.90 | RVU24A |
| 2023-10-01 | Not available in this setting | $209.14 | RVU23D |
| 2023-07-01 | Not available in this setting | $209.42 | RVU23C |
| 2023-04-01 | Not available in this setting | $209.42 | RVU23B |
| 2023-01-01 | Not available in this setting | $209.42 | RVU23A |
| 2022-10-01 | Not available in this setting | $210.92 | RVU22D |
| 2022-07-01 | Not available in this setting | $210.92 | RVU22C |
| 2022-04-01 | Not available in this setting | $210.92 | RVU22B |
| 2022-01-01 | Not available in this setting | $210.92 | RVU22A |
| 2021-10-01 | Not available in this setting | $212.68 | RVU21D |
| 2021-07-01 | Not available in this setting | $212.68 | RVU21C |
| 2021-04-01 | Not available in this setting | $212.68 | RVU21B |
| 2021-01-01 | Not available in this setting | $212.68 | RVU21A |
| 2020-10-01 | Not available in this setting | $216.81 | RVU20D |
| 2020-07-01 | Not available in this setting | $216.81 | RVU20C |
| 2020-04-01 | Not available in this setting | $216.81 | RVU20B |
| 2020-01-01 | Not available in this setting | $216.81 | RVU20A |
| 2019-10-01 | Not available in this setting | $220.81 | RVU19D |
| 2019-07-01 | Not available in this setting | $220.81 | RVU19C |
| 2019-04-01 | Not available in this setting | $218.31 | RVU19B |
| 2019-01-01 | Not available in this setting | $218.31 | RVU19A |
| 2018-10-01 | Not available in this setting | $220.93 | RVU18D |
| 2018-07-01 | Not available in this setting | $220.93 | RVU18C |
| 2018-04-01 | Not available in this setting | $220.93 | RVU18B |
| 2018-01-01 | Not available in this setting | $220.93 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $184.76 | RVU17D |
| 2017-07-01 | Not available in this setting | $184.76 | RVU17C |
| 2017-04-01 | Not available in this setting | $184.76 | RVU17B |
| 2017-01-01 | Not available in this setting | $184.76 | RVU17A |
| 2016-10-01 | Not available in this setting | $165.57 | RVU16D |
| 2016-07-01 | Not available in this setting | $165.57 | RVU16C |
| 2016-04-01 | Not available in this setting | $165.57 | RVU16B |
| 2016-01-01 | Not available in this setting | $165.57 | RVU16A |
| 2015-10-01 | Not available in this setting | $165.41 | RVU15D |
| 2015-07-01 | Not available in this setting | $165.41 | RVU15C |
| 2015-04-01 | Not available in this setting | $164.58 | RVU15B |
| 2015-01-01 | Not available in this setting | $164.58 | RVU15A |
| 2014-10-01 | Not available in this setting | $164.15 | RVU14D |
| 2014-07-01 | Not available in this setting | $164.15 | RVU14C |
| 2014-04-01 | Not available in this setting | $164.15 | RVU14B |
| 2014-01-01 | Not available in this setting | $164.15 | RVU14A |
| 2013-10-01 | Not available in this setting | $156.01 | RVU13D |
| 2013-07-01 | Not available in this setting | $156.01 | RVU13C |
| 2013-04-01 | Not available in this setting | $156.01 | RVU13B |
| 2013-01-01 | Not available in this setting | $156.01 | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
63078 billing questions
What primary code must accompany 63078?
Report 63078 with 63077 for the primary thoracic interspace. It is not reported by itself.
When is 63078 used instead of 63077?
Use 63077 for the primary thoracic interspace and 63078 for each additional thoracic interspace treated by the anterior disk procedure.
What documentation supports an additional unit?
The operative report should identify each additional thoracic interspace and describe disk removal and spinal cord or nerve root decompression there.
Is 63078 paid outside the primary procedure’s global period?
No. CMS identifies it as an add-on code paid within the primary procedure’s global period.
Does 63078 describe removal of another disk fragment?
No. It represents treatment of an additional interspace, not additional material removed from the same interspace.
How does 63078 differ from thoracic vertebral body removal?
63078 describes an additional interspace treated through an anterior disk procedure. Code 63086 is an add-on for additional thoracic vertebral body removal performed for decompression.
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
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