CPT code 63290: Spinal lesion surgery, extradural or intradural, any level2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $2,684.74 for 63290 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 63290 nationwide

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

What 63290 covers

A surgeon uses a laminectomy to reach an intraspinal lesion for tissue sampling or removal. The lesion may be extradural or intradural and may occur at any spinal level. Neurosurgeons and orthopedic spine surgeons typically perform this operation in a hospital operating room, often when imaging identifies a spinal mass or another lesion requiring tissue diagnosis or surgical treatment.

Report the code when the operative service fits the any-level extradural or intradural description; the operative report should identify the lesion, its location and compartment, the exposure performed, and whether the surgeon biopsied or excised it. This major procedure has a 90-day global period, which includes 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 Puerto Rico compares for 63290

Across 109 of 109 payment localities, the facility rate for 63290 runs from $2,262.56 in Wisconsin to $3,575.45 in Miami, FL. Puerto Rico pays $2,684.74. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

63290 rates by state

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

See 63290 in every payment locality

How the 63290 rate is calculated

Each of 63290’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 63290

63290 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

Codes related to 63290

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

How 63290 has changed in Puerto Rico

Price 63290 for an earlier date of service

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

Browse all communities in Puerto Rico

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