Billing code 63276: Spinal lesion surgeryMedicare rate & RVUs in Illinois
Reports thoracic laminectomy to biopsy or remove a neoplasm located in the spinal canal outside the dura.
CMS doesn’t publish an office rate for 63276 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 63276 covers
A neurosurgeon or spine surgeon uses a thoracic laminectomy to reach a lesion in the spinal canal that lies outside the dura, then obtains a biopsy or removes the lesion. The code is for an extradural neoplasm in the thoracic region; examples may include a tumor involving the epidural space or extending into it. The operative report should establish the lesion’s location and compartment, the thoracic level, and whether the surgeon sampled or excised it.
Select this code when the lesion is both neoplastic and extradural, rather than by the amount of tissue removed. A non-neoplastic extradural lesion and a neoplasm within the dura belong to different code choices. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 for this anatomically defined service. An assistant at surgery may be paid; 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 63276 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 | $2,160.59 |
| East St. Louis | Unavailable | $2,014.75 |
| Rest Of Illinois | Unavailable | $1,862.89 |
| Suburban Chicago | Unavailable | $2,001.42 |
How the 63276 rate is calculated
Each of 63276’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 · 63276
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 25.05Practice expense 16.84Malpractice 9.82
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63276
63276 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63276
Spinal lesion surgery
| 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 · 63276
Spinal lesion surgery
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
63276 without 51 · national facility
$1,727.16
Spinal lesion surgery
63276-51 · Second procedure: 50%
$863.58
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%).
63276 compared with similar codes
Compare codes
63276 vs 63266 vs 63271 vs 63281 vs 63277: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63266Spinal lesion excision
- Both concern thoracic extradural lesions. Choose 63276 for a neoplasm; 63266 is for an extradural lesion other than a neoplasm.
- 63271Spinal lesion excision
- 63271 concerns a thoracic intradural lesion other than a neoplasm. This code is for an extradural neoplasm.
- 63281Spinal lesion surgery
- Both address thoracic neoplasms, but 63281 is for an intradural, extramedullary lesion; this code is for an extradural lesion.
- 63277Spinal lesion surgery
- The lesion type and extradural location match, but 63277 applies to the lumbar region rather than the thoracic region.
63276 billing questions
How does this differ from 63266?
63276 is for biopsy or excision of an extradural neoplasm in the thoracic region. 63266 is for an extradural lesion other than a neoplasm.
When is 63281 a better fit?
Use 63281 for a thoracic neoplasm located within the dura but outside the spinal cord. The lesion’s relationship to the dura and cord should be clear in the operative report.
Does the code include postoperative visits?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this anatomically defined service.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery 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 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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