No office rate
63185 concerns a spinal nerve procedure with limited segment involvement. Use 63191 when the spinal accessory nerve is the operative target.
On this page
CMS RVU26D · Effective 2026-10-01
63191 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1316.24
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Neurosurgery
About 63191: Spinal accessory nerve incision
Reports operative incision or division of the spinal accessory nerve, including selected procedures for severe cervical dystonia when that nerve is the surgical target.
The surgeon exposes and incises or divides the spinal accessory nerve as the intended neural target. A neurosurgeon or other surgeon qualified to perform the procedure may use it in selected cases of severe cervical dystonia or spasmodic torticollis. The operative report should identify the spinal accessory nerve and describe the surgical work performed; procedures on spinal nerve roots or spinal cord tracts involve different targets.
Report 63191 when the documented operation is directed at the spinal accessory nerve, not simply because another cervical nerve procedure was performed. Record the indication, laterality, nerve treated, and operative details supporting the service. Medicare assigns 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 procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63191
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.45 · 45%
- Practice expense (office) RVU15.00 · 36%
- Malpractice RVU7.77 · 19%
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.
63191 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
63190 concerns a spinal nerve procedure involving more than two segments. It is not the code for incision of the spinal accessory nerve.
No office rate
63170 involves incision of spinal cord tracts. Choose 63191 when the documented target is the spinal accessory nerve instead.
The same code, a different location
How does El Centro compare?
63191 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 63191
Office
Unavailable
Facility
$1314.94
No comparable office rate is available.
Modesto
California · 63191
Office
Unavailable
Facility
$1314.94
No comparable office rate is available.
Napa
California · 63191
Office
Unavailable
Facility
$1447.24
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 63191
Office
Unavailable
Facility
$1387.38
No comparable office rate is available.
Redding
California · 63191
Office
Unavailable
Facility
$1314.94
No comparable office rate is available.
Rest Of California
California · 63191
Office
Unavailable
Facility
$1314.94
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 63191
Office
Unavailable
Facility
$1397.82
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 63191
Office
Unavailable
Facility
$1360.22
No comparable office rate is available.
Salinas
California · 63191
Office
Unavailable
Facility
$1355.13
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 63191
Office
Unavailable
Facility
$1374.61
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 63191
Office
Unavailable
Facility
$1500.34
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 63191
Office
Unavailable
Facility
$1491.52
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 63191
Office
Unavailable
Facility
$1545.60
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 63191
Office
Unavailable
Facility
$1509.53
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 63191
Office
Unavailable
Facility
$1336.48
No comparable office rate is available.
Santa Cruz-Watsonville
California · 63191
Office
Unavailable
Facility
$1377.02
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 63191
Office
Unavailable
Facility
$1356.79
No comparable office rate is available.
Santa Rosa-Petaluma
California · 63191
Office
Unavailable
Facility
$1389.08
No comparable office rate is available.
Stockton
California · 63191
Office
Unavailable
Facility
$1314.94
No comparable office rate is available.
Vallejo
California · 63191
Office
Unavailable
Facility
$1434.53
No comparable office rate is available.
Visalia
California · 63191
Office
Unavailable
Facility
$1314.94
No comparable office rate is available.
Yuba City
California · 63191
Office
Unavailable
Facility
$1314.94
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 63191
Office
Unavailable
Facility
$1528.57
No comparable office rate is available.
Miami
Florida · 63191
Office
Unavailable
Facility
$1794.14
No comparable office rate is available.
Chicago
Illinois · 63191
Office
Unavailable
Facility
$1719.69
No comparable office rate is available.
Manhattan
New York · 63191
Office
Unavailable
Facility
$1649.47
No comparable office rate is available.
Alaska*
Alaska · 63191
Office
Unavailable
Facility
$1600.95
No comparable office rate is available.
Alabama
Alabama · 63191
Office
Unavailable
Facility
$1201.52
No comparable office rate is available.
Arkansas
Arkansas · 63191
Office
Unavailable
Facility
$1180.27
No comparable office rate is available.
Arizona
Arizona · 63191
Office
Unavailable
Facility
$1323.88
No comparable office rate is available.
Colorado
Colorado · 63191
Office
Unavailable
Facility
$1359.41
No comparable office rate is available.
Connecticut
Connecticut · 63191
Office
Unavailable
Facility
$1482.19
No comparable office rate is available.
Delaware
Delaware · 63191
Office
Unavailable
Facility
$1347.64
No comparable office rate is available.
Fort Lauderdale
Florida · 63191
Office
Unavailable
Facility
$1592.99
No comparable office rate is available.
Rest Of Florida
Florida · 63191
Office
Unavailable
Facility
$1485.28
No comparable office rate is available.
Atlanta
Georgia · 63191
Office
Unavailable
Facility
$1438.81
No comparable office rate is available.
Rest Of Georgia
Georgia · 63191
Office
Unavailable
Facility
$1372.50
No comparable office rate is available.
Hawaii, Guam
Hawaii · 63191
Office
Unavailable
Facility
$1336.16
No comparable office rate is available.
Iowa
Iowa · 63191
Office
Unavailable
Facility
$1177.71
No comparable office rate is available.
Idaho
Idaho · 63191
Office
Unavailable
Facility
$1199.93
No comparable office rate is available.
East St. Louis
Illinois · 63191
Office
Unavailable
Facility
$1599.86
No comparable office rate is available.
Rest Of Illinois
Illinois · 63191
Office
Unavailable
Facility
$1479.31
No comparable office rate is available.
Suburban Chicago
Illinois · 63191
Office
Unavailable
Facility
$1594.98
No comparable office rate is available.
Indiana
Indiana · 63191
Office
Unavailable
Facility
$1206.82
No comparable office rate is available.
Kansas
Kansas · 63191
Office
Unavailable
Facility
$1199.96
No comparable office rate is available.
Kentucky
Kentucky · 63191
Office
Unavailable
Facility
$1299.11
No comparable office rate is available.
New Orleans
Louisiana · 63191
Office
Unavailable
Facility
$1382.52
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 63191
Office
Unavailable
Facility
$1308.27
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 63191
Office
Unavailable
Facility
$1470.70
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 63191
Office
Unavailable
Facility
$1360.52
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 63191
Office
Unavailable
Facility
$1484.73
No comparable office rate is available.
Rest Of Maryland
Maryland · 63191
Office
Unavailable
Facility
$1367.68
No comparable office rate is available.
Rest Of Maine
Maine · 63191
Office
Unavailable
Facility
$1238.60
No comparable office rate is available.
Southern Maine
Maine · 63191
Office
Unavailable
Facility
$1276.51
No comparable office rate is available.
Detroit
Michigan · 63191
Office
Unavailable
Facility
$1537.28
No comparable office rate is available.
Rest Of Michigan
Michigan · 63191
Office
Unavailable
Facility
$1366.68
No comparable office rate is available.
Minnesota
Minnesota · 63191
Office
Unavailable
Facility
$1208.61
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 63191
Office
Unavailable
Facility
$1340.25
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 63191
Office
Unavailable
Facility
$1353.26
No comparable office rate is available.
Rest Of Missouri
Missouri · 63191
Office
Unavailable
Facility
$1300.90
No comparable office rate is available.
Mississippi
Mississippi · 63191
Office
Unavailable
Facility
$1239.41
No comparable office rate is available.
Montana**
Montana · 63191
Office
Unavailable
Facility
$1376.27
No comparable office rate is available.
North Carolina
North Carolina · 63191
Office
Unavailable
Facility
$1249.53
No comparable office rate is available.
North Dakota**
North Dakota · 63191
Office
Unavailable
Facility
$1222.63
No comparable office rate is available.
Nebraska
Nebraska · 63191
Office
Unavailable
Facility
$1176.78
No comparable office rate is available.
New Hampshire
New Hampshire · 63191
Office
Unavailable
Facility
$1364.89
No comparable office rate is available.
Northern Nj
New Jersey · 63191
Office
Unavailable
Facility
$1513.42
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 63191
Office
Unavailable
Facility
$1472.70
No comparable office rate is available.
New Mexico
New Mexico · 63191
Office
Unavailable
Facility
$1387.37
No comparable office rate is available.
Nevada**
Nevada · 63191
Office
Unavailable
Facility
$1333.95
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 63191
Office
Unavailable
Facility
$1733.33
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 63191
Office
Unavailable
Facility
$1506.61
No comparable office rate is available.
Queens
New York · 63191
Office
Unavailable
Facility
$1622.12
No comparable office rate is available.
Rest Of New York
New York · 63191
Office
Unavailable
Facility
$1274.66
No comparable office rate is available.
Ohio
Ohio · 63191
Office
Unavailable
Facility
$1335.27
No comparable office rate is available.
Oklahoma
Oklahoma · 63191
Office
Unavailable
Facility
$1265.30
No comparable office rate is available.
Portland
Oregon · 63191
Office
Unavailable
Facility
$1375.82
No comparable office rate is available.
Rest Of Oregon
Oregon · 63191
Office
Unavailable
Facility
$1297.70
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 63191
Office
Unavailable
Facility
$1458.51
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 63191
Office
Unavailable
Facility
$1321.43
No comparable office rate is available.
Puerto Rico
Puerto Rico · 63191
Office
Unavailable
Facility
$1378.40
No comparable office rate is available.
Rhode Island
Rhode Island · 63191
Office
Unavailable
Facility
$1377.00
No comparable office rate is available.
South Carolina
South Carolina · 63191
Office
Unavailable
Facility
$1299.78
No comparable office rate is available.
South Dakota**
South Dakota · 63191
Office
Unavailable
Facility
$1204.46
No comparable office rate is available.
Tennessee
Tennessee · 63191
Office
Unavailable
Facility
$1211.03
No comparable office rate is available.
Austin
Texas · 63191
Office
Unavailable
Facility
$1377.49
No comparable office rate is available.
Beaumont
Texas · 63191
Office
Unavailable
Facility
$1313.27
No comparable office rate is available.
Brazoria
Texas · 63191
Office
Unavailable
Facility
$1320.11
No comparable office rate is available.
Dallas
Texas · 63191
Office
Unavailable
Facility
$1343.47
No comparable office rate is available.
Fort Worth
Texas · 63191
Office
Unavailable
Facility
$1341.84
No comparable office rate is available.
Galveston
Texas · 63191
Office
Unavailable
Facility
$1333.57
No comparable office rate is available.
Houston
Texas · 63191
Office
Unavailable
Facility
$1475.79
No comparable office rate is available.
Rest Of Texas
Texas · 63191
Office
Unavailable
Facility
$1326.06
No comparable office rate is available.
Utah
Utah · 63191
Office
Unavailable
Facility
$1320.25
No comparable office rate is available.
Virginia
Virginia · 63191
Office
Unavailable
Facility
$1291.97
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 63191
Office
Unavailable
Facility
$1378.40
No comparable office rate is available.
Vermont
Vermont · 63191
Office
Unavailable
Facility
$1243.57
No comparable office rate is available.
Rest Of Washington
Washington · 63191
Office
Unavailable
Facility
$1349.32
No comparable office rate is available.
Seattle (King Cnty)
Washington · 63191
Office
Unavailable
Facility
$1473.83
No comparable office rate is available.
Wisconsin
Wisconsin · 63191
Office
Unavailable
Facility
$1176.15
No comparable office rate is available.
West Virginia
West Virginia · 63191
Office
Unavailable
Facility
$1423.01
No comparable office rate is available.
Wyoming**
Wyoming · 63191
Office
Unavailable
Facility
$1309.31
No comparable office rate is available.
See how rates vary across the country
63191 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 63191 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1447.86
$1316.24 × 110% = $1447.86
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 63191 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
7,037
- Code
- 63191
- Physician work
- 18.45
- Practice expense
- 15.00
- Malpractice
- 7.77
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.45 | × 1.017 | 18.7636 |
| Practice expense | 15.00 | × 1.096 | 16.4400 |
| Malpractice | 7.77 | × 0.541 | 4.2036 |
| Total RVUs | 39.4072 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$1316.24
Open 63191 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.45 | 1.017 |
| Practice expense | 15 | 1.096 |
| Malpractice | 7.77 | 0.541 |
(18.45 × 1.017 + 15 × 1.096 + 7.77 × 0.541) × $33.4009 = $1316.24
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
63191 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1316.24 | RVU26D |
| 2026-07-01 | Not available in this setting | $1316.24 | RVU26C |
| 2026-04-01 | Not available in this setting | $1316.24 | RVU26B |
| 2026-01-01 | Not available in this setting | $1316.24 | RVU26A |
| 2025-10-01 | Not available in this setting | $1322.80 | RVU25D |
| 2025-07-01 | Not available in this setting | $1322.80 | RVU25C |
| 2025-04-01 | Not available in this setting | $1322.80 | RVU25B |
| 2025-01-01 | Not available in this setting | $1322.80 | RVU25A |
63191 billing questions
How does 63191 differ from spinal nerve root incision codes?
63191 targets the spinal accessory nerve. Codes 63185 and 63190 concern spinal nerve procedures distinguished by the extent or segment involvement.
Is this code appropriate for every operation for cervical dystonia?
No. Report it when the spinal accessory nerve is the nerve surgically incised or divided; a different operative target calls for its own code.
Can modifier 50 be used for bilateral treatment?
CMS identifies this as a bilateral procedure. Bilateral reporting with modifier 50 is paid at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
May an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,03463173,,Drainage of spinal cyst,A,,23.70,17.09,NA,17.09,,10.02,50.81,50.81,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03563185,,Incise spine nrv half segmnt,A,,16.08,14.17,NA,14.17,,6.77,37.02,37.02,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03663190,,Incise spine nrv >2 segmnts,A,,18.42,11.34,NA,11.34,,3.92,33.68,33.68,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03763191,,Incise spine accessory nerve,A,,18.45,15.00,NA,15.00,,7.77,41.22,41.22,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03863197,,Lam w/cordotomy 1stg thrc,A,,23.48,17.01,NA,17.01,,9.92,50.41,50.41,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03963200,,Release spinal cord lumbar,A,,20.90,16.33,NA,16.33,,8.73,45.96,45.96,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04063250,,Revise spinal cord vsls crvl,A,,42.76,24.05,NA,24.05,,18.05,84.86,84.86,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664