CPT code 63278: Spinal lesion surgery, sacral, extradural neoplasm2026 Medicare rate & RVUs

Medicare pays $1,579.53 for 63278 nationally in a facility.

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

What 63278 covers

A spine surgeon, commonly a neurosurgeon or orthopedic spine surgeon, uses a posterior approach and removes bone as needed to reach a lesion in the sacral spinal canal, outside the dura. The service includes obtaining tissue for diagnosis or removing the lesion; it is performed in an operating room, typically in a hospital setting. The sacral location and extradural position distinguish this service from procedures for lesions at other spinal levels or within the dura.

Select the code when the operative findings and report support a sacral extradural neoplasm and document whether tissue was sampled or the lesion removed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this sacral service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery billing 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 63278 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

63278 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 63278 rate is calculated

Each of 63278’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 63278

63278 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

63278 compared with similar codes

How to choose

63277Spinal lesion surgeryExtradural, lumbar

Both address extradural spinal neoplasms, but 63277 is for the lumbar region and 63278 is for the sacral region. Use the documented operative level.

63283Spinal tumor surgeryIntradural, extramedullary, sacral

Both address sacral neoplasms, but 63283 is for a lesion within the dura. This code is for a lesion outside the dura.

63268Spinal lesion excisionSacral, extradural, nonneoplastic

This code is for biopsy or removal of a sacral extradural neoplasm; 63268 is for a sacral extradural lesion other than a neoplasm.

Codes related to 63278

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