CPT code 63268: Spinal lesion excision, sacral, extradural, nonneoplastic2026 Medicare rate & RVUs in Missouri
Reports laminectomy-based removal or evacuation of a nonneoplastic lesion outside the dura in the sacral spinal canal.
CMS doesn’t publish an office rate for 63268 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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What 63268 covers
A neurosurgeon or orthopedic spine surgeon uses a laminectomy approach to remove or evacuate a nonneoplastic lesion in the sacral spinal canal that lies outside the dura. Examples include an extradural abscess or hematoma. The operative report should establish the sacral level, extradural location, and nonneoplastic nature of the lesion, as well as the work performed to remove or evacuate it.
Choose this code for the sacral level and extradural, nonneoplastic lesion type; a lesion inside the dura or a neoplasm follows a different code pathway. This major surgery has 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 the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons are paid only with 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 63268 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 | $1,418.93 |
| Metropolitan St. Louis, MO | Unavailable | $1,432.71 |
| Rest of Missouri | Unavailable | $1,377.26 |
How the 63268 rate is calculated
Each of 63268’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 · 63268
RVUs × geographic indexes × conversion factor
Work19.52
19.52 RVUs× 1.000 GPCI
Practice expense15.88
15.88 RVUs× 1.000 GPCI
Malpractice8.24
8.24 RVUs× 1.000 GPCI
Adjusted RVUs
43.6400
Conversion factor
$33.4009
Medicare rate
$1,457.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63268
63268 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63268
Spinal lesion excision, sacral, 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 · 63268
Spinal lesion excision, sacral, 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
63268 without 51 · national facility
$1,457.62
Spinal lesion excision, sacral, extradural, nonneoplastic
63268-51 · Second procedure: 50%
$728.81
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%).
63268 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 63267Spinal lesion excisionLumbar, extradural, non-neoplastic
- Both address nonneoplastic extradural lesions, but 63267 is for the lumbar region; 63268 is for the sacral region.
- 63273Spinal lesion surgeryIntradural, sacral
- Use 63268 for an extradural sacral lesion and 63273 when the sacral lesion is intradural and extramedullary.
- 63278Spinal lesion surgerySacral, extradural neoplasm
- Both concern sacral extradural lesions, but 63278 is for a neoplasm; 63268 is for a nonneoplastic lesion.
- 63283Spinal tumor surgeryIntradural, extramedullary, sacral
- 63283 addresses a sacral lesion that is both intradural and extramedullary and is treated through the neoplasm biopsy or excision pathway.
63268 billing questions
How is this code distinguished from the lumbar version?
This code is for the sacral region. Use the lumbar sibling when the treated extradural lesion is at a lumbar level.
Does this code cover an intradural lesion?
No. It describes treatment of a lesion outside the dura; an intradural lesion belongs to a different code pathway.
Can it be reported for an extradural neoplasm?
This code is for a nonneoplastic lesion. The operative documentation should support the lesion type as well as its sacral level and extradural location.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgery requires supporting documentation.
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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