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CPT code 63250: Spinal AVM surgery2026 Medicare rate & RVUs

Reports cervical-level surgery to remove or occlude a spinal cord arteriovenous malformation through a laminectomy approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities23 Medicare services in 2024

Medicare pays $2,834.40 for 63250 nationally in a facility.

Medicare rate · 63250

Spinal AVM surgery

Work RVUs
42.76
Total RVUs
84.86
Global days
090

National rate · 2026

$2,834.40

Facility setting, before claim adjustments.

See every locality for 63250 →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 63250 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 63250 covers

This code describes operative treatment of an arteriovenous malformation involving the spinal cord at a cervical level, using a laminectomy approach to expose and remove or occlude the abnormal vessels. Neurosurgeons typically perform the procedure in a hospital operating room, often with microsurgical techniques. The operative report should establish the vascular malformation, the cervical location, and the treatment performed.

Select this code for the cervical spinal level; thoracic and thoracolumbar locations have separate sibling codes. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require 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 63250 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

63250 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,472.34
Alaska*Unavailable$3,330.03
ArizonaUnavailable$2,722.68
ArkansasUnavailable$2,428.74
AtlantaUnavailable$2,972.72
AustinUnavailable$2,815.12
BakersfieldUnavailable$2,702.92
Baltimore/Surr. CntysUnavailable$3,058.78
BeaumontUnavailable$2,719.30
BrazoriaUnavailable$2,705.96

63250 rates by state

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

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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
63250 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 63250 rate is calculated

Each of 63250’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 · 63250

RVUs × geographic indexes × conversion factor

Work42.76

42.76 RVUs× 1.000 GPCI

Practice expense24.05

24.05 RVUs× 1.000 GPCI

Malpractice18.05

18.05 RVUs× 1.000 GPCI

Adjusted RVUs

84.8600

Conversion factor

$33.4009

Medicare rate

$2,834.40

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 63250

63250 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63250

Spinal AVM surgery

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 · 63250

Spinal AVM surgery

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

63250 without 51 · national facility

$2,834.40

Spinal AVM surgery

63250-51 · Second procedure: 50%

$1,417.20

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

63250 compared with similar codes

Compare codes · National

4 codes, side by side

  • 63250

    Spinal AVM surgery42.76 wRVU

    Not priced

  • 63251

    Spinal vascular surgery43.52 wRVU

    Not priced

  • 63252

    Spinal vascular surgery43.51 wRVU

    Not priced

  • 63270

    Spinal lesion excision29.06 wRVU

    Not priced

How to choose

63251Spinal vascular surgery
Use 63251 when the treated spinal cord arteriovenous malformation is at the thoracic level; this code is for the cervical level.
63252Spinal vascular surgery
Use 63252 for the thoracolumbar level. This code identifies cervical-level treatment.
63270Spinal lesion excision
Code 63270 describes excision of an intramedullary cervical spinal lesion, rather than the excision or occlusion of a spinal cord arteriovenous malformation.

Codes related to 63250

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

Codes related to 63250
CodeHow it relatesNational office range
Same family
63251Spinal vascular surgerySibling code for spinal cord arteriovenous malformation surgery at the thoracic level.No office rate
63252Spinal vascular surgerySibling code for spinal cord arteriovenous malformation surgery at the thoracolumbar level.No office rate

63250 billing questions

How do I distinguish this code from 63251 or 63252?

Use this code for a cervical spinal cord arteriovenous malformation. Code 63251 identifies the thoracic level, and 63252 identifies the thoracolumbar level.

Does this code describe excision of any cervical spinal lesion?

No. It describes operative treatment of a spinal cord arteriovenous malformation. Other intraspinal lesion excision codes describe different lesion types or procedures.

What documentation supports this code?

The operative report should identify the arteriovenous malformation, its cervical location, and whether it was removed or occluded through the operative approach.

Can modifier 50 be used for bilateral treatment?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for its descriptor and anatomy.

How are other procedures in the same session paid?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation.

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 63250PPRRVU2026_Oct_nonQPP.csv, line 7,040 (RVU26D)

Open CMS sourceHow we calculate rates

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