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Billing code 63266: Spinal lesion excisionMedicare rate & RVUs

Reports surgical removal or evacuation of a nonneoplastic lesion outside the dura in the thoracic spinal canal, such as an epidural abscess.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $1,658.02 for 63266 nationally in a facility.

Medicare rate · 63266

Spinal lesion excision

Swap in your local Medicare rate.

Work RVUs
24.06
Total RVUs
49.64
Global days
090

National rate · 2026

$1,658.02

Facility setting, before claim adjustments.

See every locality for 63266 → · 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 63266 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 63266 covers

A neurosurgeon or other qualified spine surgeon uses a thoracic exposure, commonly with laminectomy, to reach and remove or evacuate a lesion in the spinal canal but outside the dura. Examples include an epidural abscess or hematoma. The defining distinctions are the thoracic location, extradural compartment, and nonneoplastic nature of the lesion; an intradural lesion or a spinal neoplasm belongs to a different code pathway.

Select the code from the operative findings and report: documentation should identify the thoracic level, the lesion’s extradural location and nonneoplastic character, and the removal or evacuation performed. CMS assigns major-surgery status with 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 is paid in full and the others at 50%. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 63266 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

63266 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,455.75
Alaska*Unavailable$1,956.56
ArizonaUnavailable$1,596.62
ArkansasUnavailable$1,431.27
AtlantaUnavailable$1,731.26
AustinUnavailable$1,656.04
BakersfieldUnavailable$1,604.85
Baltimore/Surr. CntysUnavailable$1,783.92
BeaumontUnavailable$1,587.00
BrazoriaUnavailable$1,591.57

63266 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
63266 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 63266 rate is calculated

Each of 63266’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 · 63266

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 24.06Practice expense 16.33Malpractice 9.25

49.6400 adjusted RVUs×$33.4009 conversion factor=$1,658.02

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

Payment rules and modifiers for 63266

63266 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63266

Spinal lesion excision

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 · 63266

Spinal lesion excision

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

63266 without 51 · national facility

$1,658.02

Spinal lesion excision

63266-51 · Second procedure: 50%

$829.01

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

63266 compared with similar codes

Compare codes

63266 vs 63265 vs 63271 vs 63276: national Medicare rates

Swap in your local Medicare rate.

  • 63266
    Spinal lesion excision · 24.06 wRVU
    —
  • 63265
    Spinal lesion removal · 23.22 wRVU
    —
  • 63271
    Spinal lesion excision · 29.17 wRVU
    —
  • 63276
    Spinal lesion surgery · 25.05 wRVU
    —

How to choose

63265Spinal lesion removal
Use 63265 for a nonneoplastic extradural lesion in the cervical region; this code is for the thoracic region.
63271Spinal lesion excision
Use 63271 when the thoracic lesion is intradural and extramedullary. This code is for an extradural lesion.
63276Spinal lesion surgery
Use 63276 for biopsy or excision of an extradural thoracic spinal neoplasm. This code is for a nonneoplastic lesion.

Codes related to 63266

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

Codes related to 63266
CodeHow it relatesNational office range
Same family
63265Spinal lesion removalSame nonneoplastic extradural lesion procedure family for the cervical region.No office rate
63267Spinal lesion excisionSame nonneoplastic extradural lesion procedure family for the lumbar region.No office rate
63268Spinal lesion excisionSame nonneoplastic extradural lesion procedure family for the sacral region.No office rate
Used instead
63270Spinal lesion excisionExcision or evacuation of an intradural, extramedullary lesion in the cervical region.No office rate
63271Spinal lesion excisionExcision or evacuation of an intradural, extramedullary lesion in the thoracic region.No office rate
63276Spinal lesion surgeryBiopsy or excision of an extradural thoracic spinal neoplasm.No office rate

63266 billing questions

How is this distinguished from code 63270?

This code is for a nonneoplastic lesion outside the dura in the thoracic canal. Code 63270 describes excision or evacuation of an intradural, extramedullary lesion in the cervical region.

When would code 63276 be more appropriate?

Use 63276 for biopsy or excision of an extradural thoracic spinal neoplasm. This code describes removal or evacuation of a nonneoplastic extradural lesion.

What operative documentation supports the code?

Document the thoracic level, that the lesion is extradural and nonneoplastic, and the removal or evacuation performed. The operative report should make the lesion’s compartment clear.

Can modifier 50 be reported?

No. The thoracic operative anatomy and descriptor make modifier 50 inappropriate for this code.

How does the global period affect postoperative billing?

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

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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 63266PPRRVU2026_Oct_nonQPP.csv, line 7,044 (RVU26D)

Open CMS sourceHow we calculate rates

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