No office rate
Use 63265 for a nonneoplastic extradural lesion in the cervical region; this code is for the thoracic region.
On this page
CMS RVU26D · Effective 2026-10-01
63266 Spinal lesion excision Medicare reimbursement rates in Illinois
Reports surgical removal or evacuation of a nonneoplastic lesion outside the dura in the thoracic spinal canal, such as an epidural abscess. Compare 63266 office and facility rates across CMS payment localities in Illinois.
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.
What does Medicare pay for 63266 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1784.51–$2066.47
4 of 4 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 63266 pays more and less in Illinois
Neurosurgery
About 63266: Thoracic extradural spinal lesion excision
Reports surgical removal or evacuation of a nonneoplastic lesion outside the dura in the thoracic spinal canal, such as an epidural abscess.
A neurosurgeon or other qualified spine surgeon uses a thoracic exposure, commonly with laminectomy, to reach and remove or evacuate a lesion in the spinal canal but outside the dura. Examples include an epidural abscess or hematoma. The defining distinctions are the thoracic location, extradural compartment, and nonneoplastic nature of the lesion; an intradural lesion or a spinal neoplasm belongs to a different code pathway.
Select the code from the operative findings and report: documentation should identify the thoracic level, the lesion’s extradural location and nonneoplastic character, and the removal or evacuation performed. CMS assigns major-surgery status with 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 is paid in full and the others at 50%. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 63266
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU24.06 · 48%
- Practice expense (office) RVU16.33 · 33%
- Malpractice RVU9.25 · 19%
1.5K
Medicare services in 2024 · #2692 by national volume
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.
63266 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Use 63271 when the thoracic lesion is intradural and extramedullary. This code is for an extradural lesion.
No office rate
Use 63276 for biopsy or excision of an extradural thoracic spinal neoplasm. This code is for a nonneoplastic lesion.
Compare 63266 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$2066.47
East St. Louis →
Office / nonfacility
Unavailable
Facility
$1927.67
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1784.51
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$1916.89
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63266 billing questions
How is this distinguished from code 63270?
This code is for a nonneoplastic lesion outside the dura in the thoracic canal. Code 63270 describes excision or evacuation of an intradural, extramedullary lesion in the cervical region.
When would code 63276 be more appropriate?
Use 63276 for biopsy or excision of an extradural thoracic spinal neoplasm. This code describes removal or evacuation of a nonneoplastic extradural lesion.
What operative documentation supports the code?
Document the thoracic level, that the lesion is extradural and nonneoplastic, and the removal or evacuation performed. The operative report should make the lesion’s compartment clear.
Can modifier 50 be reported?
No. The thoracic operative anatomy and descriptor make modifier 50 inappropriate for this code.
How does the global period affect postoperative billing?
The major-surgery global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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.
7,04163251,,Revise spinal cord vsls thrc,A,,43.52,25.07,NA,25.07,,18.37,86.96,86.96,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04263252,,Revise spine cord vsl thrlmb,A,,43.51,25.06,NA,25.06,,18.37,86.94,86.94,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04363265,,Excise intraspinl lesion crv,A,,23.22,16.09,NA,16.09,,9.00,48.31,48.31,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04463266,,Excise intrspinl lesion thrc,A,,24.06,16.33,NA,16.33,,9.25,49.64,49.64,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04563267,,Excise intrspinl lesion lmbr,A,,18.96,13.93,NA,13.93,,6.71,39.60,39.60,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04663268,,Excise intrspinl lesion scrl,A,,19.52,15.88,NA,15.88,,8.24,43.64,43.64,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04763270,,Excise intrspinl lesion crvl,A,,29.06,19.23,NA,19.23,,12.28,60.57,60.57,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00