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Billing code 63290: Spinal lesion surgeryMedicare rate & RVUs

Reports laminectomy exposure to biopsy or remove an extradural or intradural spinal lesion when the service is not limited to a specific spinal level.

CMS RVU26DEffective Oct 1, 2026109 payment localities40 Medicare services in 2024

Medicare pays $2,684.43 for 63290 nationally in a facility.

Medicare rate · 63290

Spinal lesion surgery

Swap in your local Medicare rate.

Work RVUs
39.8
Total RVUs
80.37
Global days
090

National rate · 2026

$2,684.43

Facility setting, before claim adjustments.

See every locality for 63290 → · 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 63290 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 63290 covers

A surgeon uses a laminectomy to reach an intraspinal lesion for tissue sampling or removal. The lesion may be extradural or intradural and may occur at any spinal level. Neurosurgeons and orthopedic spine surgeons typically perform this operation in a hospital operating room, often when imaging identifies a spinal mass or another lesion requiring tissue diagnosis or surgical treatment.

Report the code when the operative service fits the any-level extradural or intradural description; the operative report should identify the lesion, its location and compartment, the exposure performed, and whether the surgeon biopsied or excised it. This major procedure has a 90-day global period, which includes 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 63290 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

63290 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,341.55
Alaska*Unavailable$3,148.59
ArizonaUnavailable$2,578.98
ArkansasUnavailable$2,300.22
AtlantaUnavailable$2,813.97
AustinUnavailable$2,669.11
BakersfieldUnavailable$2,566.34
Baltimore/Surr. CntysUnavailable$2,896.70
BeaumontUnavailable$2,573.14
BrazoriaUnavailable$2,564.40

63290 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
63290 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 63290 rate is calculated

Each of 63290’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 · 63290

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 39.80Practice expense 23.76Malpractice 16.81

80.3700 adjusted RVUs×$33.4009 conversion factor=$2,684.43

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

Payment rules and modifiers for 63290

63290 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63290

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 · 63290

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

63290 without 51 · national facility

$2,684.43

Spinal lesion surgery

63290-51 · Second procedure: 50%

$1,342.22

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

63290 compared with similar codes

Compare codes

63290 vs 63275 vs 63280 vs 63265: national Medicare rates

Swap in your local Medicare rate.

  • 63290
    Spinal lesion surgery · 39.8 wRVU
    —
  • 63275
    Spinal lesion surgery · 25.21 wRVU
    —
  • 63280
    Spinal tumor surgery · 29.53 wRVU
    —
  • 63265
    Spinal lesion removal · 23.22 wRVU
    —

How to choose

63275Spinal lesion surgery
This code describes the cervical region specifically and an extradural lesion. Code 63290 covers an extradural or intradural lesion at any level.
63280Spinal tumor surgery
This code is specific to a cervical intradural lesion. Code 63290 is the any-level option for an extradural or intradural lesion.
63265Spinal lesion removal
Code 63265 is for excision or evacuation of an extradural lesion other than a neoplasm at a specified spinal region; code 63290 covers biopsy or excision at any level.

Codes related to 63290

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

Codes related to 63290
CodeHow it relatesNational office range
Same family
63275Spinal lesion surgeryLevel-specific extradural spinal lesion biopsy or excision code for the cervical region.No office rate
63276Spinal lesion surgeryLevel-specific extradural spinal lesion biopsy or excision code for the thoracic region.No office rate
63280Spinal tumor surgeryLevel-specific intradural spinal lesion biopsy or excision code for the cervical region.No office rate
63281Spinal lesion surgeryLevel-specific intradural spinal lesion biopsy or excision code for the thoracic region.No office rate
Used instead
63265Spinal lesion removalFor excision or evacuation of an extradural intraspinal lesion other than a neoplasm, at a specified level.No office rate

63290 billing questions

How does this code differ from the level-specific spinal lesion codes?

This code describes an extradural or intradural lesion at any level. Codes 63275–63278 and 63280–63283 identify specific spinal regions, so use the code matching the documented level when that description applies.

Does the code cover biopsy as well as removal?

Yes. It covers laminectomy exposure for biopsy or excision of the lesion. The operative report should make clear which service was performed.

Can modifier 50 be used for lesions on both sides?

No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

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. The surgeon's related routine care during that period is not separately reported as another service.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. The operative record should support each distinct procedure reported.

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 63290PPRRVU2026_Oct_nonQPP.csv, line 7,062 (RVU26D)

Open CMS sourceHow we calculate rates

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