Billing code 63003: Thoracic decompressionMedicare rate & RVUs in Illinois
Reports posterior thoracic canal decompression across one or two vertebral segments, such as for stenosis compressing the spinal cord.
CMS doesn’t publish an office rate for 63003 in Illinois.
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 63003 covers
A spine surgeon removes part of the posterior vertebral arch to enlarge the thoracic spinal canal and decompress the spinal cord across one or two vertebral segments. A typical clinical situation is thoracic spinal stenosis with cord compression or myelopathy. This code describes decompression without the additional work of facetectomy, foraminotomy, or discectomy. The service is generally performed in an operating room, commonly in a hospital facility, by an orthopedic spine surgeon or neurosurgeon.
Select the code based on the thoracic region, the number of segments treated, and the work documented in the operative report. The report should identify the treated segments and describe the decompression performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery and co-surgeon services may be paid; 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 63003 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,483.58 |
| East St. Louis | Unavailable | $1,384.52 |
| Rest Of Illinois | Unavailable | $1,284.38 |
| Suburban Chicago | Unavailable | $1,379.63 |
How the 63003 rate is calculated
Each of 63003’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 · 63003
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.30Practice expense 12.11Malpractice 6.46
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63003
63003 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63003
Thoracic 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) | 2 | Permitted. |
| 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 · 63003
Thoracic 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
63003 without 51 · national facility
$1,198.09
Thoracic decompression
63003-51 · Second procedure: 50%
$599.05
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%).
63003 compared with similar codes
Compare codes
63003 vs 63016 vs 63046 vs 63005 vs 63055: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63016Laminectomy
- Both describe thoracic canal decompression; choose 63003 for one or two segments and 63016 when more than two segments are treated.
- 63046Thoracic decompression
- 63003 is for decompression without facetectomy or foraminotomy. Choose 63046 when the thoracic decompression includes those procedures.
- 63005Lumbar laminectomy
- The segment range is similar, but 63005 applies to the lumbar region; 63003 applies to the thoracic region.
- 63055Spinal decompression
- 63055 describes thoracic cord decompression through a transpedicular approach; 63003 describes posterior canal decompression without that approach.
63003 billing questions
How does this differ from 63046?
63003 describes thoracic canal decompression without facetectomy or foraminotomy. 63046 is for thoracic decompression that includes facetectomy and foraminotomy.
What should the operative report document?
Document the thoracic vertebral segments treated and the decompression performed. The record should support that the service involved one or two segments and did not include the additional facetectomy, foraminotomy, or discectomy work described by other procedures.
Is modifier 50 appropriate for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS allows payment for an assistant at surgery and permits co-surgeons. 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
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