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Billing code 63055: Spinal decompressionMedicare rate & RVUs

Reports posterior transpedicular decompression at one thoracic spinal segment, commonly for a disc herniation compressing the cord or nerve roots.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare pays $1,553.14 for 63055 nationally in a facility.

Medicare rate · 63055

Spinal decompression

Swap in your local Medicare rate.

Work RVUs
22.96
Total RVUs
46.50
Global days
090

National rate · 2026

$1,553.14

Facility setting, before claim adjustments.

See every locality for 63055 → · 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 63055 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 63055 covers

A spine surgeon, commonly an orthopedic spine surgeon or neurosurgeon, uses a posterior transpedicular route to reach and decompress neural structures at one thoracic segment. A typical situation is a thoracic disc herniation compressing the spinal cord or nerve roots when this route is selected for access. Medicare claims for this service are predominantly for facility procedures.

Report one unit for the documented thoracic segment treated with this approach. The operative report should identify the spinal level, transpedicular route, compressive pathology, and decompression performed. Code 63057 is the add-on for each additional segment when its requirements are met. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that 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 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 63055 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

63055 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,366.51
Alaska*Unavailable$1,840.73
ArizonaUnavailable$1,496.46
ArkansasUnavailable$1,343.93
AtlantaUnavailable$1,620.92
AustinUnavailable$1,551.10
BakersfieldUnavailable$1,503.95
Baltimore/Surr. CntysUnavailable$1,669.70
BeaumontUnavailable$1,487.81
BrazoriaUnavailable$1,491.87

63055 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
63055 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 63055 rate is calculated

Each of 63055’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 · 63055

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.96Practice expense 14.98Malpractice 8.56

46.5000 adjusted RVUs×$33.4009 conversion factor=$1,553.14

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

Payment rules and modifiers for 63055

63055 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63055

Spinal 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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 63055

Spinal 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

63055 without 51 · national facility

$1,553.14

Spinal decompression

63055-51 · Second procedure: 50%

$776.57

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

63055 compared with similar codes

Compare codes

63055 vs 63056 vs 63057 vs 63064 vs 63046: national Medicare rates

Swap in your local Medicare rate.

  • 63055
    Spinal decompression · 22.96 wRVU
    —
  • 63056
    Spinal decompression · 21.31 wRVU
    —
  • 63057
    Spinal decompression · 5.12 wRVU
    —
  • 63064
    Spinal decompression · 25.56 wRVU
    —
  • 63046
    Thoracic decompression · 16.82 wRVU
    —

How to choose

63056Spinal decompression
Use 63055 for a thoracic segment and 63056 for a lumbar segment when the transpedicular decompression approach is performed.
63057Spinal decompression
63055 reports the primary thoracic segment; 63057 is the add-on for each additional segment and is not reported alone.
63064Spinal decompression
Both address thoracic spinal cord decompression, but 63064 describes a costovertebral route rather than the transpedicular route represented by 63055.
63046Thoracic decompression
63046 describes thoracic decompression through a laminectomy, facetectomy, and foraminotomy approach; 63055 is selected for the transpedicular approach.

Codes related to 63055

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

Codes related to 63055
CodeHow it relatesNational office range
Add-on codes
63057Spinal decompressionAdd-on for each additional segment treated after the primary transpedicular decompression.No office rate
Same family
63056Spinal decompressionTranspedicular decompression for a lumbar rather than thoracic segment.No office rate
Used instead
63064Spinal decompressionThoracic cord decompression using a costovertebral approach rather than a transpedicular route.No office rate
63046Thoracic decompressionThoracic posterior decompression for a different operative approach and pathology.No office rate

63055 billing questions

How is this different from code 63056?

Both describe transpedicular decompression, but 63055 is for a thoracic segment and 63056 is for a lumbar segment. Select the code based on the treated spinal region.

When can code 63057 be reported with 63055?

Code 63057 is the add-on for each additional segment when more than one segment is treated. Document each level and the work performed; do not use it as a standalone primary procedure.

Should modifier 50 be used for bilateral decompression?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on the documented segment and applicable coding instructions.

What documentation supports reporting 63055?

The operative report should establish the thoracic level, transpedicular approach, compressive condition, and decompression performed. It should also distinguish any additional segment treated.

How does the 90-day global period affect postoperative billing?

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

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 63055PPRRVU2026_Oct_nonQPP.csv, line 7,012 (RVU26D)

Open CMS sourceHow we calculate rates

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