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CPT code 63091: Vertebral body removal, additional lumbar segment2026 Medicare rate & RVUs

Reports removal of an additional lumbar vertebral segment for spinal cord or nerve root decompression after the primary lumbar vertebral body procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities515 Medicare services in 2024

Medicare pays $157.99 for 63091 nationally in a facility.

Medicare rate · 63091

Vertebral body removal, additional lumbar segment

Office or facility?

Work RVUs
2.95
Total RVUs
4.73
Global days
ZZZ

National rate · 2026

$157.99

Facility setting, before claim adjustments.

See every locality for 63091 →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 63091 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 63091 covers

This add-on describes removal of another lumbar vertebral body segment through an anterior approach as part of decompression of the spinal cord or nerve roots. A spine surgeon or neurosurgeon may perform the work in a hospital operating room for conditions requiring decompression at multiple lumbar levels. The code represents an additional segment, not a separate primary operation or removal of additional bone within the same segment.

Report 63091 only with the primary lumbar procedure, 63090. The operative report should identify the lumbar levels treated, the additional vertebral segment removed, the anterior approach, and the decompression performed. CMS classifies 63091 as an add-on code, so 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.

Where 63091 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

63091 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$141.78
AlaskaUnavailable$196.52
ArizonaUnavailable$152.94
ArkansasUnavailable$139.84
Atlanta, GAUnavailable$164.49
Austin, TXUnavailable$156.75
Bakersfield, CAUnavailable$151.74
Baltimore area, MDUnavailable$168.56
Beaumont, TXUnavailable$153.17
Brazoria, TXUnavailable$152.25

63091 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
63091 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 63091 rate is calculated

Each of 63091’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 · 63091

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.95

2.95 RVUs× 1.000 GPCI

Practice expense0.93

0.93 RVUs× 1.000 GPCI

Malpractice0.85

0.85 RVUs× 1.000 GPCI

Adjusted RVUs

4.7300

Conversion factor

$33.4009

Medicare rate

$157.99

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

Payment rules and modifiers for 63091

The CMS indicators that decide how 63091 is paid alongside other services.

CMS payment indicators · 63091

Vertebral body removal, additional lumbar segment

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)2Permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

63091 without 80 · national facility

$157.99

Vertebral body removal, additional lumbar segment

63091-80 · Assistant: 16%

$25.28

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

63091 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 63091

    Vertebral body removal, additional lumbar segment2.95 wRVU

    Not priced

  • 63090

    Vertebral corpectomy, lumbar, abdominal approach30.16 wRVU

    Not priced

  • 63088

    Vertebral resection, additional thoracolumbar segment4.21 wRVU

    Not priced

  • 63056

    Spinal decompression, lumbar, single segment21.31 wRVU

    Not priced

How to choose

63090Vertebral corpectomyLumbar, abdominal approach
63090 is the primary lumbar vertebral body removal and decompression procedure. 63091 is reported for an additional lumbar segment during that procedure.
63088Vertebral resectionAdditional thoracolumbar segment
63088 describes an additional vertebral segment in the thoracolumbar region. 63091 is the additional-segment code for the lumbar region.
63056Spinal decompressionLumbar, single segment
63056 describes lumbar decompression through a transpedicular approach. 63091 is for removal of an additional lumbar vertebral segment through an anterior approach with decompression.

Codes related to 63091

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

Codes related to 63091
CodeHow it relatesNational office range
Add-on codes
63090Vertebral corpectomy, lumbar, abdominal approachPrimary lumbar vertebral body removal procedure reported with this add-on.No office rate
Same family
63088Vertebral resection, additional thoracolumbar segmentAdditional-segment vertebral body removal code for the thoracolumbar region.No office rate
63086Vertebral corpectomy, each additional thoracic segmentAdditional-segment vertebral body removal code for the thoracic region.No office rate
63082Vertebral decompression, additional cervical segmentAdditional-segment vertebral body removal code for the cervical region.No office rate
63087Vertebral body removal, thoracolumbar, single segmentPrimary vertebral body removal code for the thoracolumbar region.No office rate

63091 billing questions

Can 63091 be reported by itself?

No. It is an add-on code and is reported with the primary lumbar vertebral body removal procedure, 63090.

How is 63091 different from 63090?

63090 reports the primary lumbar vertebral segment removal. Use 63091 for an additional lumbar vertebral segment treated during the procedure.

What should the operative report document?

Document the anterior approach, decompression, and each lumbar vertebral segment removed, including which segment is additional to the primary level.

How are units determined?

Report the additional segment or segments treated, rather than counting bone fragments or separate pieces removed from one segment.

How does 63091 differ from 63088?

Both describe an additional vertebral segment removal, but 63091 is for the lumbar region; 63088 is for the thoracolumbar region.

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

Show the CMS file lines behind this rate
RVUs for 63091PPRRVU2026_Oct_nonQPP.csv, line 7,028 (RVU26D)

Open CMS sourceHow we calculate rates

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