FeeBase
Log inGet started
Menu

Billing code 63268: Spinal lesion excisionMedicare rate & RVUs

Reports laminectomy-based removal or evacuation of a nonneoplastic lesion outside the dura in the sacral spinal canal.

CMS RVU26DEffective Oct 1, 2026109 payment localities77 Medicare services in 2024

Medicare pays $1,457.62 for 63268 nationally in a facility.

Medicare rate · 63268

Spinal lesion excision

Swap in your local Medicare rate.

Work RVUs
19.52
Total RVUs
43.64
Global days
090

National rate · 2026

$1,457.62

Facility setting, before claim adjustments.

See every locality for 63268 → · 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 63268 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 63268 covers

A neurosurgeon or orthopedic spine surgeon uses a laminectomy approach to remove or evacuate a nonneoplastic lesion in the sacral spinal canal that lies outside the dura. Examples include an extradural abscess or hematoma. The operative report should establish the sacral level, extradural location, and nonneoplastic nature of the lesion, as well as the work performed to remove or evacuate it.

Choose this code for the sacral level and extradural, nonneoplastic lesion type; a lesion inside the dura or a neoplasm follows a different code pathway. This major surgery has 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 the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons are paid only with 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 63268 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

63268 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,271.87
Alaska*Unavailable$1,694.51
ArizonaUnavailable$1,401.54
ArkansasUnavailable$1,249.34
AtlantaUnavailable$1,523.38
AustinUnavailable$1,458.31
BakersfieldUnavailable$1,413.31
Baltimore/Surr. CntysUnavailable$1,571.99
BeaumontUnavailable$1,390.34
BrazoriaUnavailable$1,397.51

63268 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
63268 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 63268 rate is calculated

Each of 63268’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 · 63268

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 19.52Practice expense 15.88Malpractice 8.24

43.6400 adjusted RVUs×$33.4009 conversion factor=$1,457.62

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

Payment rules and modifiers for 63268

63268 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63268

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 · 63268

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

63268 without 51 · national facility

$1,457.62

Spinal lesion excision

63268-51 · Second procedure: 50%

$728.81

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

63268 compared with similar codes

Compare codes

63268 vs 63267 vs 63273 vs 63278 vs 63283: national Medicare rates

Swap in your local Medicare rate.

  • 63268
    Spinal lesion excision · 19.52 wRVU
    —
  • 63267
    Spinal lesion excision · 18.96 wRVU
    —
  • 63273
    Spinal lesion surgery · 25.81 wRVU
    —
  • 63278
    Spinal lesion surgery · 21.57 wRVU
    —
  • 63283
    Spinal tumor surgery · 26.09 wRVU
    —

How to choose

63267Spinal lesion excision
Both address nonneoplastic extradural lesions, but 63267 is for the lumbar region; 63268 is for the sacral region.
63273Spinal lesion surgery
Use 63268 for an extradural sacral lesion and 63273 when the sacral lesion is intradural and extramedullary.
63278Spinal lesion surgery
Both concern sacral extradural lesions, but 63278 is for a neoplasm; 63268 is for a nonneoplastic lesion.
63283Spinal tumor surgery
63283 addresses a sacral lesion that is both intradural and extramedullary and is treated through the neoplasm biopsy or excision pathway.

Codes related to 63268

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

Codes related to 63268
CodeHow it relatesNational office range
Same family
63267Spinal lesion excisionLumbar-level counterpart for excision or evacuation of a nonneoplastic extradural lesion.No office rate
63265Spinal lesion removalCervical-level counterpart for the same nonneoplastic extradural lesion service.No office rate
Used instead
63273Spinal lesion surgerySacral lesion service for an intradural, extramedullary lesion rather than an extradural lesion.No office rate
63278Spinal lesion surgerySacral extradural lesion pathway when the lesion is a neoplasm.No office rate
63283Spinal tumor surgerySacral intradural, extramedullary neoplasm pathway.No office rate

63268 billing questions

How is this code distinguished from the lumbar version?

This code is for the sacral region. Use the lumbar sibling when the treated extradural lesion is at a lumbar level.

Does this code cover an intradural lesion?

No. It describes treatment of a lesion outside the dura; an intradural lesion belongs to a different code pathway.

Can it be reported for an extradural neoplasm?

This code is for a nonneoplastic lesion. The operative documentation should support the lesion type as well as its sacral level and extradural location.

What postoperative care is included?

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

Can modifier 50 be used for bilateral treatment?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are multiple procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgery 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 63268PPRRVU2026_Oct_nonQPP.csv, line 7,046 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 63268 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 63268 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 →