Billing code 63190: Spinal rhizotomyMedicare rate & RVUs in Florida
Report open spinal nerve root sectioning across more than two segments, such as a selective rhizotomy performed to address severe spasticity.
CMS doesn’t publish an office rate for 63190 in Florida.
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 63190 covers
This service is an open rhizotomy in which the surgeon interrupts spinal nerve roots across more than two segments. Neurosurgeons commonly perform selective dorsal rhizotomy for severe spasticity, including in patients with cerebral palsy, in a hospital operating room. The operative target is the spinal nerve roots; a procedure that instead interrupts pathways within the spinal cord is a different service.
Choose this code when the documented operative extent exceeds two segments, and ensure the operative report identifies the levels and roots treated. The procedure has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For other procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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 63190 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,235.66 |
| Miami | Unavailable | $1,340.67 |
| Rest Of Florida | Unavailable | $1,174.14 |
How the 63190 rate is calculated
Each of 63190’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 · 63190
RVUs × geographic indexes × conversion factor
Work18.42
18.42 RVUs× 1.000 GPCI
Practice expense11.34
11.34 RVUs× 1.000 GPCI
Malpractice3.92
3.92 RVUs× 1.000 GPCI
Adjusted RVUs
33.6800
Conversion factor
$33.4009
Medicare rate
$1,124.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63190
63190 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63190
Spinal rhizotomy
| 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 · 63190
Spinal rhizotomy
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
63190 without 51 · national facility
$1,124.94
Spinal rhizotomy
63190-51 · Second procedure: 50%
$562.47
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%).
63190 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 63185Spinal rhizotomy
- Choose 63190 for spinal nerve root sectioning across more than two segments; 63185 represents a half-segment extent.
- 63170Spinal cord surgery
- 63190 treats spinal nerve roots. Code 63170 involves interruption of spinal cord tracts.
- 63191Nerve incision
- 63190 involves spinal nerve roots across more than two segments; 63191 identifies a procedure directed at the spinal accessory nerve.
63190 billing questions
How does this differ from 63185?
63190 is for open spinal nerve root sectioning across more than two segments. Code 63185 is the related option for a half-segment extent.
What should the operative report document?
Document the spinal levels and roots treated and show that the operative extent exceeds two segments. The report should also describe the indication and the procedure performed.
Can modifier 50 be used for bilateral root treatment?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are related postoperative visits included?
Yes. 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 paid at 50% under the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 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
Fee sheets
Put 63190 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 →