FeeBase
Log inGet started
Menu

Billing code 63265: Spinal lesion removalMedicare rate & RVUs

Reports cervical laminectomy to remove or evacuate a nonneoplastic lesion outside the dura, such as an epidural abscess or hematoma.

CMS RVU26DEffective Oct 1, 2026109 payment localities782 Medicare services in 2024

Medicare pays $1,613.60 for 63265 nationally in a facility.

Medicare rate · 63265

Spinal lesion removal

Swap in your local Medicare rate.

Work RVUs
23.22
Total RVUs
48.31
Global days
090

National rate · 2026

$1,613.60

Facility setting, before claim adjustments.

See every locality for 63265 → · 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 63265 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 63265 covers

A neurosurgeon or spine surgeon uses a cervical laminectomy to reach and remove or evacuate a lesion in the spinal canal but outside the dura. Typical situations include surgery for a cervical epidural abscess or hematoma. The lesion must be nonneoplastic; the code is not selected just because a lesion is found during a cervical spine operation. The operative report should establish the cervical level, extradural location, nonneoplastic nature, and removal or evacuation performed.

Report the service for the lesion operation, including the laminectomy exposure used to reach it, rather than separately coding that exposure. CMS assigns a 90-day global period, including 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 other procedures are subject to the standard 50% multiple-procedure reduction. A bilateral adjustment is not appropriate. 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 63265 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

63265 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,415.96
Alaska*Unavailable$1,901.34
ArizonaUnavailable$1,553.65
ArkansasUnavailable$1,392.03
AtlantaUnavailable$1,684.95
AustinUnavailable$1,612.05
BakersfieldUnavailable$1,562.39
Baltimore/Surr. CntysUnavailable$1,736.48
BeaumontUnavailable$1,543.89
BrazoriaUnavailable$1,548.83

63265 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
63265 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 63265 rate is calculated

Each of 63265’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 · 63265

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 23.22Practice expense 16.09Malpractice 9.00

48.3100 adjusted RVUs×$33.4009 conversion factor=$1,613.60

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

Payment rules and modifiers for 63265

63265 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63265

Spinal lesion removal

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 · 63265

Spinal lesion removal

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

63265 without 51 · national facility

$1,613.60

Spinal lesion removal

63265-51 · Second procedure: 50%

$806.80

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

63265 compared with similar codes

Compare codes

63265 vs 63270 vs 63275 vs 63266: national Medicare rates

Swap in your local Medicare rate.

  • 63265
    Spinal lesion removal · 23.22 wRVU
    —
  • 63270
    Spinal lesion excision · 29.06 wRVU
    —
  • 63275
    Spinal lesion surgery · 25.21 wRVU
    —
  • 63266
    Spinal lesion excision · 24.06 wRVU
    —

How to choose

63270Spinal lesion excision
Both concern nonneoplastic cervical spinal lesions, but this code is for an extradural lesion; 63270 is for an intradural, extramedullary lesion.
63275Spinal lesion surgery
Use this code for a nonneoplastic extradural cervical lesion. Code 63275 is for biopsy or excision of a neoplastic extradural lesion.
63266Spinal lesion excision
The lesion type and extradural location are comparable, but 63266 applies to the thoracic region rather than the cervical region.

Codes related to 63265

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

Codes related to 63265
CodeHow it relatesNational office range
Same family
63266Spinal lesion excisionCorresponding nonneoplastic extradural lesion removal code for the thoracic region.No office rate
63267Spinal lesion excisionCorresponding nonneoplastic extradural lesion removal code for the lumbar region.No office rate
63268Spinal lesion excisionCorresponding nonneoplastic extradural lesion removal code for the sacral region.No office rate
Used instead
63270Spinal lesion excisionFor a nonneoplastic lesion inside the dura but outside the spinal cord, rather than an extradural lesion.No office rate
63275Spinal lesion surgeryFor biopsy or excision of a neoplastic extradural cervical spinal lesion.No office rate

63265 billing questions

How does this differ from code 63270?

This code is for a nonneoplastic lesion outside the dura. Code 63270 is for a nonneoplastic lesion inside the dura but outside the spinal cord.

When would code 63275 be used instead?

Code 63275 describes biopsy or excision of an extradural cervical spinal lesion when the lesion is neoplastic. This code is for a nonneoplastic extradural lesion.

Can the cervical laminectomy exposure be billed separately?

The laminectomy exposure used to reach and remove or evacuate the lesion is part of this operative service; do not separately report it for the same exposure.

Does modifier 50 apply to bilateral cervical levels?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.

What documentation supports reporting this code?

Document the cervical site, that the lesion is extradural and nonneoplastic, and the removal or evacuation performed. The operative report should make the lesion compartment clear.

How are assistant and co-surgeon services handled?

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 63265PPRRVU2026_Oct_nonQPP.csv, line 7,043 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 63265 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 63265 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →