CPT code 63290: Spinal lesion surgery, extradural or intradural, any level2026 Medicare rate & RVUs in Texas
Reports laminectomy exposure to biopsy or remove an extradural or intradural spinal lesion when the service is not limited to a specific spinal level.
CMS doesn’t publish an office rate for 63290 in Texas.
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 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.
Where 63290 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $2,669.11 |
| Beaumont, TX | Unavailable | $2,573.14 |
| Brazoria, TX | Unavailable | $2,564.40 |
| Dallas, TX | Unavailable | $2,613.49 |
| Fort Worth, TX | Unavailable | $2,612.85 |
| Galveston, TX | Unavailable | $2,592.94 |
| Houston, TX | Unavailable | $2,900.62 |
| Rest of Texas | Unavailable | $2,589.49 |
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.
How the rate is built · 63290
RVUs × geographic indexes × conversion factor
Work39.80
39.80 RVUs× 1.000 GPCI
Practice expense23.76
23.76 RVUs× 1.000 GPCI
Malpractice16.81
16.81 RVUs× 1.000 GPCI
Adjusted RVUs
80.3700
Conversion factor
$33.4009
Medicare rate
$2,684.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63290
63290 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63290
Spinal lesion surgery, extradural or intradural, any level
| 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 · 63290
Spinal lesion surgery, extradural or intradural, any level
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
63290 without 51 · national facility
$2,684.43
Spinal lesion surgery, extradural or intradural, any level
63290-51 · Second procedure: 50%
$1,342.22
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%).
63290 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 63275Spinal lesion surgeryCervical, extradural
- This code describes the cervical region specifically and an extradural lesion. Code 63290 covers an extradural or intradural lesion at any level.
- 63280Spinal tumor surgeryCervical, intradural extramedullary
- This code is specific to a cervical intradural lesion. Code 63290 is the any-level option for an extradural or intradural lesion.
- 63265Spinal lesion removalCervical extradural, nonneoplastic
- Code 63265 is for excision or evacuation of an extradural lesion other than a neoplasm at a specified spinal region; code 63290 covers biopsy or excision at any level.
63290 billing questions
How does this code differ from the level-specific spinal lesion codes?
This code describes an extradural or intradural lesion at any level. Codes 63275–63278 and 63280–63283 identify specific spinal regions, so use the code matching the documented level when that description applies.
Does the code cover biopsy as well as removal?
Yes. It covers laminectomy exposure for biopsy or excision of the lesion. The operative report should make clear which service was performed.
Can modifier 50 be used for lesions on both sides?
No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The surgeon's related routine care during that period is not separately reported as another service.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What happens when another procedure is performed during the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. The operative record should support each distinct procedure reported.
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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