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Billing code 63281: Spinal lesion surgeryMedicare rate & RVUs

Reports thoracic spinal surgery to biopsy or remove a lesion located inside the dura, including intradural extramedullary tumors such as meningiomas or schwannomas.

CMS RVU26DEffective Oct 1, 2026109 payment localities705 Medicare services in 2024

Medicare pays $2,046.47 for 63281 nationally in a facility.

Medicare rate · 63281

Spinal lesion surgery

Swap in your local Medicare rate.

Work RVUs
29.24
Total RVUs
61.27
Global days
090

National rate · 2026

$2,046.47

Facility setting, before claim adjustments.

See every locality for 63281 → · 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 63281 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 63281 covers

A neurosurgeon uses a posterior approach, commonly with laminectomy or laminoplasty and opening of the dura, to obtain tissue from or remove a lesion within the thoracic spinal canal. Typical cases include an intradural extramedullary meningioma or schwannoma. The code identifies the thoracic location and intradural compartment; it is not the code for a lesion outside the dura or within the spinal cord substance. These procedures are generally performed in a hospital operating room.

Select the code when the operative report supports both the thoracic level and the lesion’s intradural location, and describes whether the surgeon biopsied or excised it. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy.

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 63281 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

63281 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,786.83
Alaska*Unavailable$2,394.88
ArizonaUnavailable$1,967.26
ArkansasUnavailable$1,755.45
AtlantaUnavailable$2,141.91
AustinUnavailable$2,040.39
BakersfieldUnavailable$1,969.28
Baltimore/Surr. CntysUnavailable$2,207.03
BeaumontUnavailable$1,957.93
BrazoriaUnavailable$1,958.68

63281 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
63281 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 63281 rate is calculated

Each of 63281’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 · 63281

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 29.24Practice expense 19.83Malpractice 12.20

61.2700 adjusted RVUs×$33.4009 conversion factor=$2,046.47

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

Payment rules and modifiers for 63281

63281 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63281

Spinal lesion 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 · 63281

Spinal lesion 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.

  • 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

63281 without 51 · national facility

$2,046.47

Spinal lesion surgery

63281-51 · Second procedure: 50%

$1,023.24

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

63281 compared with similar codes

Compare codes

63281 vs 63276 vs 63286 vs 63280: national Medicare rates

Swap in your local Medicare rate.

  • 63281
    Spinal lesion surgery · 29.24 wRVU
    —
  • 63276
    Spinal lesion surgery · 25.05 wRVU
    —
  • 63286
    Spinal lesion surgery · 36.68 wRVU
    —
  • 63280
    Spinal tumor surgery · 29.53 wRVU
    —

How to choose

63276Spinal lesion surgery
Use 63281 for an intradural thoracic lesion; 63276 describes a thoracic lesion approached in the extradural compartment.
63286Spinal lesion surgery
Use 63281 for an intradural lesion outside the cord substance. Code 63286 is for an intradural lesion within the spinal cord.
63280Spinal tumor surgery
Both address intradural spinal lesions, but 63280 is for the cervical region and 63281 is for the thoracic region.

Codes related to 63281

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

Codes related to 63281
CodeHow it relatesNational office range
Same family
63280Spinal tumor surgeryCorresponding intradural spinal lesion code for the cervical level.No office rate
63282Spinal lesion surgeryCorresponding intradural spinal lesion code for the lumbar level.No office rate
63283Spinal tumor surgeryCorresponding intradural spinal lesion code for the sacral level.No office rate
Used instead
63276Spinal lesion surgeryThoracic lesion procedure for an extradural rather than intradural location.No office rate
63286Spinal lesion surgeryThoracic intradural procedure when the lesion is within the spinal cord substance.No office rate

63281 billing questions

How does this differ from code 63276?

This code is for a lesion inside the dura at a thoracic level. Code 63276 describes the extradural approach to a thoracic spinal lesion.

How does this differ from code 63286?

Code 63286 is for an intradural lesion within the spinal cord substance. This code identifies an intradural lesion outside the cord substance.

Can the code be reported for biopsy or excision?

It covers the thoracic intradural lesion service when the surgeon biopsies the lesion or removes it. The operative report should make the procedure and lesion location clear.

Can modifier 50 be used for bilateral thoracic lesions?

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

How does the 90-day global period affect postoperative billing?

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

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. An assistant at surgery may be paid; co-surgeons require 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 63281PPRRVU2026_Oct_nonQPP.csv, line 7,056 (RVU26D)

Open CMS sourceHow we calculate rates

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