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Billing code 63056: Spinal decompressionMedicare rate & RVUs

Reports lumbar decompression performed through a transpedicular approach to relieve pressure on neural structures at one spinal segment.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.7K Medicare services in 2024

Medicare pays $1,404.84 for 63056 nationally in a facility.

Medicare rate · 63056

Spinal decompression

Swap in your local Medicare rate.

Work RVUs
21.31
Total RVUs
42.06
Global days
090

National rate · 2026

$1,404.84

Facility setting, before claim adjustments.

See every locality for 63056 → · 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 63056 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 63056 covers

A spine surgeon uses a transpedicular route through a lumbar vertebra to reach and decompress neural structures, such as when a herniated disc or another extradural lesion is compressing them. The code describes work at one lumbar segment. This is an operative service, typically performed in a hospital or other surgical facility by an orthopedic spine surgeon or neurosurgeon.

Report the code when the operative documentation supports both the transpedicular approach and decompression at a single lumbar segment. Identify the treated level, compressive pathology, and work performed; a routine lumbar laminotomy or decompression by a different approach is not this service. The day-before preoperative visit and 90 days of related postoperative care are included in its 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 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; 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 63056 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

63056 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,244.31
Alaska*Unavailable$1,682.85
ArizonaUnavailable$1,356.33
ArkansasUnavailable$1,224.85
AtlantaUnavailable$1,462.31
AustinUnavailable$1,405.33
BakersfieldUnavailable$1,368.43
Baltimore/Surr. CntysUnavailable$1,506.04
BeaumontUnavailable$1,347.01
BrazoriaUnavailable$1,353.84

63056 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
63056 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 63056 rate is calculated

Each of 63056’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 · 63056

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.31Practice expense 13.59Malpractice 7.16

42.0600 adjusted RVUs×$33.4009 conversion factor=$1,404.84

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

Payment rules and modifiers for 63056

63056 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63056

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 · 63056

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

63056 without 51 · national facility

$1,404.84

Spinal decompression

63056-51 · Second procedure: 50%

$702.42

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

63056 compared with similar codes

Compare codes

63056 vs 63030 vs 63047 vs 63055 vs 63057: national Medicare rates

Swap in your local Medicare rate.

  • 63056
    Spinal decompression · 21.31 wRVU
    —
  • 63030
    Lumbar decompression · 11.7 wRVU
    —
  • 63047
    Lumbar decompression · 14.99 wRVU
    —
  • 63055
    Spinal decompression · 22.96 wRVU
    —
  • 63057
    Spinal decompression · 5.12 wRVU
    —

How to choose

63030Lumbar decompression
Choose 63056 for a transpedicular approach to lumbar neural decompression at one segment. Code 63030 describes a laminotomy approach to lumbar nerve-root decompression.
63047Lumbar decompression
Code 63047 describes lumbar decompression using laminectomy, facetectomy, and foraminotomy. It is distinct from the transpedicular approach represented by 63056.
63055Spinal decompression
The two codes share the transpedicular decompression approach, but 63055 is for a thoracic segment and 63056 is for a lumbar segment.
63057Spinal decompression
Code 63057 is for each additional qualifying segment; 63056 reports the primary lumbar segment.

Codes related to 63056

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

Codes related to 63056
CodeHow it relatesNational office range
Add-on codes
63057Spinal decompressionAdditional-segment lumbar decompression reported with the primary transpedicular service.No office rate
Same family
63055Spinal decompressionTranspedicular decompression at a thoracic rather than lumbar segment.No office rate
Used instead
63030Lumbar decompressionLumbar nerve-root decompression using a laminotomy approach.No office rate
63047Lumbar decompressionLumbar decompression for stenosis using laminectomy, facetectomy, and foraminotomy.No office rate

63056 billing questions

How does this differ from lumbar code 63030?

This code is for decompression through a transpedicular approach. Code 63030 describes lumbar nerve-root decompression through a laminotomy approach, often for a disc herniation.

When is code 63057 reported with this service?

Code 63057 describes decompression at each additional segment and may be reported when the surgeon performs the qualifying work at another segment. Document the additional level and work separately.

Can modifier 50 be used for this code?

No. The single-segment lumbar service is not reported as a bilateral procedure, so modifier 50 is inappropriate.

What documentation supports code 63056?

The operative report should identify the lumbar level, the transpedicular route, the compressive lesion, and the neural decompression performed.

Are the related postoperative visits separately reported?

Related postoperative care during the 90-day global period is included. The day-before preoperative visit is also included.

Can an assistant surgeon or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 63056PPRRVU2026_Oct_nonQPP.csv, line 7,013 (RVU26D)

Open CMS sourceHow we calculate rates

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