Billing code 63064: Spinal decompressionMedicare rate & RVUs in Delaware
Reports decompression of the spinal cord or nerve root at one thoracic segment when the surgeon uses a costovertebral approach.
CMS doesn’t publish an office rate for 63064 in Delaware.
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 9 sections
What 63064 covers
This service involves reaching a thoracic spinal lesion through a costovertebral exposure and decompressing the spinal cord or nerve root at one segment. The surgeon may remove bone or address a herniated thoracic disk as part of the decompression. Spine surgeons, including orthopedic surgeons and neurosurgeons, typically perform it in a hospital or other facility operating room.
Select the code when the documented approach is costovertebral and the work treats one thoracic segment; identify the level, pathology, approach, and decompression performed. For additional segments, billing code add-on code 63066 may be reported with this primary procedure when its requirements are met. The 90-day global period includes the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons require 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.
63064 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,652.53 |
How the 63064 rate is calculated
Each of 63064’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 · 63064
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 25.56Practice expense 15.66Malpractice 9.25
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63064
63064 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63064
Spinal decompression
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 63064
Spinal decompression
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
63064 without 51 · national facility
$1,685.74
Spinal decompression
63064-51 · Second procedure: 50%
$842.87
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%).
63064 compared with similar codes
Compare codes
63064 vs 63055 vs 63066 vs 63046 vs 63077: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63055Spinal decompression
- Choose 63064 for a costovertebral approach to thoracic decompression; choose 63055 when the surgeon uses a transpedicular approach.
- 63066Spinal decompression
- 63064 represents the primary thoracic segment. Code 63066 is the add-on for each additional segment treated through the costovertebral approach.
- 63046Thoracic decompression
- 63046 describes thoracic laminectomy, facetectomy, and foraminotomy decompression. Use 63064 when the documented operation uses the costovertebral approach.
- 63077Thoracic disc surgery
- 63077 describes thoracic disk surgery through a different approach; 63064 is selected for costovertebral spinal cord or nerve-root decompression.
63064 billing questions
How does this differ from 63055?
Both describe thoracic spinal cord decompression, but 63064 uses a costovertebral approach. Code 63055 is for a transpedicular approach.
Can 63066 be reported with 63064?
billing code add-on code 63066 may be reported for an additional thoracic segment treated through the costovertebral approach. Documentation should establish the additional level and work.
Is disk removal separately reported?
Disk removal performed as part of the decompression is included in this service. Do not separately report another procedure for the same disk work.
Should modifier 50 be used for bilateral work?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
What documentation supports code selection?
Document the thoracic level, the costovertebral approach, the condition treated, and the decompression performed. If additional segments are treated, identify each one.
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
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