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Billing code 63046: Thoracic decompressionMedicare rate & RVUs

Reports surgical decompression of the spinal cord or nerve roots at one thoracic vertebral segment for stenosis using bone removal and foraminal enlargement.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.5K Medicare services in 2024

Medicare pays $1,184.40 for 63046 nationally in a facility.

Medicare rate · 63046

Thoracic decompression

Swap in your local Medicare rate.

Work RVUs
16.82
Total RVUs
35.46
Global days
090

National rate · 2026

$1,184.40

Facility setting, before claim adjustments.

See every locality for 63046 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 63046 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 63046 covers

A spine surgeon uses this service to relieve thoracic spinal canal, lateral recess, or foraminal narrowing at one vertebral segment. The operation removes portions of the lamina and facet and enlarges the foramen to free the spinal cord or affected nerve roots. It is commonly performed in a hospital operating room for thoracic stenosis causing cord compression or radicular symptoms.

Select the code by the thoracic location and the single vertebral segment treated, not by the number of sides or nerve roots decompressed. The operative report should identify the segment, the stenosis, and the decompression performed. A further treated segment may support the add-on code 63048. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. 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 multiple-procedure reduction. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery and co-surgeon services may be paid; 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 63046 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

63046 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,047.33
Alaska*Unavailable$1,407.22
ArizonaUnavailable$1,143.43
ArkansasUnavailable$1,030.66
AtlantaUnavailable$1,231.51
AustinUnavailable$1,188.65
BakersfieldUnavailable$1,161.47
Baltimore/Surr. CntysUnavailable$1,270.28
BeaumontUnavailable$1,132.01
BrazoriaUnavailable$1,142.83

63046 rates by state

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

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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
63046 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 63046 rate is calculated

Each of 63046’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 · 63046

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.82Practice expense 12.90Malpractice 5.74

35.4600 adjusted RVUs×$33.4009 conversion factor=$1,184.40

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 63046

63046 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63046

Thoracic decompression

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 63046

Thoracic decompression

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

63046 without 51 · national facility

$1,184.40

Thoracic decompression

63046-51 · Second procedure: 50%

$592.20

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%).

When to use modifier 51

63046 compared with similar codes

Compare codes

63046 vs 63045 vs 63047 vs 63048 vs 63055: national Medicare rates

Swap in your local Medicare rate.

  • 63046
    Thoracic decompression · 16.82 wRVU
    —
  • 63045
    Cervical decompression · 17.5 wRVU
    —
  • 63047
    Lumbar decompression · 14.99 wRVU
    —
  • 63048
    Spinal decompression · 3.38 wRVU
    —
  • 63055
    Spinal decompression · 22.96 wRVU
    —

How to choose

63045Cervical decompression
Use 63045 for the comparable decompression in the cervical region; 63046 is for a thoracic segment.
63047Lumbar decompression
Use 63047 for the comparable decompression in the lumbar region; 63046 is thoracic.
63048Spinal decompression
63048 is an add-on for an additional treated segment. It is not the primary code for the first segment.
63055Spinal decompression
63055 describes thoracic decompression through a transpedicular approach. Choose based on the approach and service documented, not just the thoracic location.

Codes related to 63046

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

Codes related to 63046
CodeHow it relatesNational office range
Add-on codes
63048Spinal decompressionAdd-on code for each additional vertebral segment treated after the primary decompression.No office rate
Same family
63045Cervical decompressionCorresponding laminectomy, facetectomy, and foraminotomy service for a cervical segment.No office rate
63047Lumbar decompressionCorresponding laminectomy, facetectomy, and foraminotomy service for a lumbar segment.No office rate
Used instead
63055Spinal decompressionThoracic spinal cord or nerve-root decompression using a transpedicular approach.No office rate

63046 billing questions

How is 63046 different from 63045 or 63047?

63046 is for a thoracic segment. Use 63045 for the cervical region and 63047 for the lumbar region when the procedure is otherwise the same.

Can 63046 be reported for more than one thoracic segment?

Report 63046 for the first treated thoracic segment and consider add-on code 63048 for each additional segment supported by the operative report.

Should modifier 50 be added when both sides are decompressed?

CMS prices 63046 as bilateral, so modifier 50 does not increase payment. The code represents the treated segment rather than a separate charge for each side.

What postoperative care is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid for this operation?

CMS permits payment for an assistant at surgery and co-surgeons for 63046. Team surgery is not permitted.

How does CMS handle 63046 when another procedure is performed in the same session?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.

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
RVUs for 63046PPRRVU2026_Oct_nonQPP.csv, line 7,005 (RVU26D)

Open CMS sourceHow we calculate rates

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