CPT code 63265: Spinal lesion removal, cervical extradural, nonneoplastic2026 Medicare rate & RVUs in South Dakota
Reports cervical laminectomy to remove or evacuate a nonneoplastic lesion outside the dura, such as an epidural abscess or hematoma.
In South Dakota, Medicare pays $1,413.99 for 63265 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 63265 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 63265 covers
A neurosurgeon or spine surgeon uses a cervical laminectomy to reach and remove or evacuate a lesion in the spinal canal but outside the dura. Typical situations include surgery for a cervical epidural abscess or hematoma. The lesion must be nonneoplastic; the code is not selected just because a lesion is found during a cervical spine operation. The operative report should establish the cervical level, extradural location, nonneoplastic nature, and removal or evacuation performed.
Report the service for the lesion operation, including the laminectomy exposure used to reach it, rather than separately coding that exposure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. A bilateral adjustment is not appropriate. 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.
How South Dakota compares for 63265
Across 109 of 109 payment localities, the facility rate for 63265 runs from $1,383.01 in Wisconsin to $2,095.26 in Miami, FL. South Dakota pays $1,413.99. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$1,413.99
- Los Angeles, CA · California$1,642.74+$228.75
- Washington, DC area · District of Columbia$1,785.11+$371.12
- Miami, FL · Florida$2,095.26+$681.27
- Chicago, IL · Illinois$2,011.00+$597.01
- Manhattan, NY · New York$1,926.45+$512.46
- Alaska · Alaska$1,901.34+$487.35
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $1,415.96 |
| ArkansasArkansas | — | $1,392.03 |
| ArizonaArizona | — | $1,553.65 |
| Bakersfield, CACalifornia | — | $1,562.39 |
| Chico, CACalifornia | — | $1,538.89 |
| El Centro, CACalifornia | — | $1,540.40 |
| Fresno, CACalifornia | — | $1,538.89 |
| Hanford, CACalifornia | — | $1,538.89 |
| Madera, CACalifornia | — | $1,538.89 |
| Merced, CACalifornia | — | $1,538.89 |
| Modesto, CACalifornia | — | $1,538.89 |
| Napa, CACalifornia | — | $1,685.46 |
| Oxnard, CACalifornia | — | $1,619.79 |
| Redding, CACalifornia | — | $1,538.89 |
| Rest of CaliforniaCalifornia | — | $1,538.89 |
| Riverside, CACalifornia | — | $1,634.96 |
| Sacramento, CACalifornia | — | $1,589.64 |
| Salinas, CACalifornia | — | $1,583.61 |
| San Diego, CACalifornia | — | $1,604.52 |
| Marin County, CACalifornia | — | $1,744.99 |
| San Francisco, CACalifornia | — | $1,734.77 |
| San Benito County, CACalifornia | — | $1,796.97 |
| Santa Clara County, CACalifornia | — | $1,755.18 |
| San Luis Obispo, CACalifornia | — | $1,562.00 |
| Santa Cruz, CACalifornia | — | $1,605.95 |
| Santa Maria, CACalifornia | — | $1,585.04 |
| Santa Rosa, CACalifornia | — | $1,619.91 |
| Stockton, CACalifornia | — | $1,538.89 |
| Vallejo, CACalifornia | — | $1,670.73 |
| Visalia, CACalifornia | — | $1,538.89 |
| Yuba City, CACalifornia | — | $1,538.89 |
| ColoradoColorado | — | $1,591.47 |
| ConnecticutConnecticut | — | $1,733.62 |
| DelawareDelaware | — | $1,580.66 |
| Fort Lauderdale, FLFlorida | — | $1,863.48 |
| Rest of FloridaFlorida | — | $1,741.16 |
| Atlanta, GAGeorgia | — | $1,684.95 |
| Rest of GeorgiaGeorgia | — | $1,613.27 |
| Hawaii, Guam, HIHawaii | — | $1,560.67 |
| IowaIowa | — | $1,386.65 |
| IdahoIdaho | — | $1,412.18 |
| East St. Louis, ILIllinois | — | $1,875.42 |
| Rest of IllinoisIllinois | — | $1,736.08 |
| Suburban Chicago, ILIllinois | — | $1,865.61 |
| IndianaIndiana | — | $1,419.85 |
| KansasKansas | — | $1,412.90 |
| KentuckyKentucky | — | $1,528.39 |
| New Orleans, LALouisiana | — | $1,622.77 |
| Rest of LouisianaLouisiana | — | $1,539.17 |
| Metropolitan Boston, MAMassachusetts | — | $1,716.59 |
| Rest of MassachusettsMassachusetts | — | $1,593.47 |
| Baltimore area, MDMaryland | — | $1,736.48 |
| Rest of MarylandMaryland | — | $1,603.15 |
| Rest of MaineMaine | — | $1,456.97 |
| Southern Maine, MEMaine | — | $1,497.84 |
| Detroit, MIMichigan | — | $1,801.00 |
| Rest of MichiganMichigan | — | $1,605.62 |
| MinnesotaMinnesota | — | $1,417.55 |
| Metropolitan Kansas City, MOMissouri | — | $1,573.90 |
| Metropolitan St. Louis, MOMissouri | — | $1,588.40 |
| Rest of MissouriMissouri | — | $1,531.62 |
| MississippiMississippi | — | $1,460.44 |
| MontanaMontana | — | $1,613.00 |
| North CarolinaNorth Carolina | — | $1,469.07 |
| North DakotaNorth Dakota | — | $1,435.04 |
| NebraskaNebraska | — | $1,385.24 |
| New HampshireNew Hampshire | — | $1,598.06 |
| Northern New JerseyNew Jersey | — | $1,768.89 |
| Rest of New JerseyNew Jersey | — | $1,723.22 |
| New MexicoNew Mexico | — | $1,629.41 |
| NevadaNevada | — | $1,563.93 |
| NYC suburbs and Long Island, NYNew York | — | $2,022.43 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,762.68 |
| Queens, NYNew York | — | $1,893.91 |
| Rest of New YorkNew York | — | $1,497.45 |
| OhioOhio | — | $1,569.25 |
| OklahomaOklahoma | — | $1,489.06 |
| Portland, OROregon | — | $1,608.70 |
| Rest of OregonOregon | — | $1,522.17 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,707.61 |
| Rest of PennsylvaniaPennsylvania | — | $1,553.00 |
| Puerto RicoPuerto Rico | — | $1,615.00 |
| Rhode IslandRhode Island | — | $1,613.60 |
| South CarolinaSouth Carolina | — | $1,527.66 |
| TennesseeTennessee | — | $1,425.51 |
| Austin, TXTexas | — | $1,612.05 |
| Beaumont, TXTexas | — | $1,543.89 |
| Brazoria, TXTexas | — | $1,548.83 |
| Dallas, TXTexas | — | $1,575.74 |
| Fort Worth, TXTexas | — | $1,574.28 |
| Galveston, TXTexas | — | $1,564.34 |
| Houston, TXTexas | — | $1,729.07 |
| Rest of TexasTexas | — | $1,557.03 |
| UtahUtah | — | $1,550.69 |
| VirginiaVirginia | — | $1,516.08 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,615.00 |
| VermontVermont | — | $1,459.72 |
| Rest of WashingtonWashington | — | $1,580.32 |
| King County, WAWashington | — | $1,719.36 |
| WisconsinWisconsin | — | $1,383.01 |
| West VirginiaWest Virginia | — | $1,672.76 |
| WyomingWyoming | — | $1,535.44 |
63265 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 63265 rate is calculated
Each of 63265’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 · 63265
RVUs × geographic indexes × conversion factor
Work23.22
23.22 RVUs× 1.000 GPCI
Practice expense16.09
16.09 RVUs× 1.000 GPCI
Malpractice9.00
9.00 RVUs× 1.000 GPCI
Adjusted RVUs
48.3100
Conversion factor
$33.4009
Medicare rate
$1,613.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,043
- Code
- 63265
- Physician work
- 23.22
- Practice expense
- 16.09
- Malpractice
- 9.00
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.22 | × 1.000 | 23.2200 |
| Practice expense | 16.09 | × 1.000 | 16.0900 |
| Malpractice | 9.00 | × 0.336 | 3.0240 |
| Total RVUs | 42.3340 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, South Dakota$1413.99
Facility: (23.22 × 1 + 16.09 × 1 + 9 × 0.336) × $33.4009 = $1413.99
Payment rules and modifiers for 63265
63265 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63265
Spinal lesion removal, cervical extradural, nonneoplastic
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 63265
Spinal lesion removal, cervical extradural, nonneoplastic
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
63265 without 51 · national facility
$1,613.60
Spinal lesion removal, cervical extradural, nonneoplastic
63265-51 · Second procedure: 50%
$806.80
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 63265 has changed in South Dakota
63265 · 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 | $1,413.99 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,413.99 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,413.99 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,413.99 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,468.92 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,468.92 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,468.92 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,468.92 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,504.77 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,504.77 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,504.77 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,504.77 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,480.21 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,517.30 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,517.30 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,517.30 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,517.30 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,527.11 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,527.11 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,527.11 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,527.11 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,531.62 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,531.62 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,531.62 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,531.62 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,555.38 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,555.38 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,555.38 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,555.38 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,559.31 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,559.31 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,559.31 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,559.31 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,559.26 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,559.26 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,559.26 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,559.26 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,560.16 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,560.16 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,560.16 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,560.16 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,560.57 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,560.57 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,560.57 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,560.57 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,569.43 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,569.43 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,561.62 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,561.62 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,551.33 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,551.33 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,551.33 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,551.33 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,535.48 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,535.48 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,535.48 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,535.48 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
63265 billing questions
How does this differ from code 63270?
This code is for a nonneoplastic lesion outside the dura. Code 63270 is for a nonneoplastic lesion inside the dura but outside the spinal cord.
When would code 63275 be used instead?
Code 63275 describes biopsy or excision of an extradural cervical spinal lesion when the lesion is neoplastic. This code is for a nonneoplastic extradural lesion.
Can the cervical laminectomy exposure be billed separately?
The laminectomy exposure used to reach and remove or evacuate the lesion is part of this operative service; do not separately report it for the same exposure.
Does modifier 50 apply to bilateral cervical levels?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
What documentation supports reporting this code?
Document the cervical site, that the lesion is extradural and nonneoplastic, and the removal or evacuation performed. The operative report should make the lesion compartment clear.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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