No office rate
The operative approach is for an extradural lesion in either case; 63276 identifies the thoracic level, while 63275 identifies the cervical level.
On this page
CMS RVU26D · Effective 2026-10-01
63275 Spinal lesion surgery Medicare reimbursement rates in Indiana
Reports operative biopsy or removal of a lesion outside the dura in the cervical spinal canal, typically through posterior bony exposure. Compare 63275 office and facility rates across CMS payment localities in Indiana.
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 63275 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1522.82
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
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.
Neurosurgery
About 63275: Cervical extradural lesion biopsy or excision
Reports operative biopsy or removal of a lesion outside the dura in the cervical spinal canal, typically through posterior bony exposure.
A neurosurgeon uses posterior bony exposure of the cervical spine to reach a lesion in the spinal canal but outside the dura. The service may involve obtaining tissue for diagnosis, removing the lesion, or both. A typical situation is an epidural mass identified on imaging and approached surgically for tissue sampling or removal.
Select the code based on the cervical location, extradural compartment, and work documented—not simply the eventual pathology result. The operative report should describe the exposure, lesion location relative to the dura, and whether biopsy, excision, or both were performed. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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 cervical service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 63275
- 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 RVU25.21 · 49%
- Practice expense (office) RVU16.86 · 33%
- Malpractice RVU9.78 · 19%
234
Medicare services in 2024 · #4189 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.
63275 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
Both concern a cervical intraspinal lesion, but 63275 is for a lesion outside the dura and 63280 for one within it.
No office rate
Consider 63270 for excision of a cervical extradural intraspinal neoplasm. Code 63275 describes biopsy or excision of an extradural lesion.
No office rate
Code 63265 describes excision or evacuation of a cervical extradural lesion other than a neoplasm; 63275 describes biopsy or excision.
Compare 63275 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.
1 of 1 payment localities
Indiana →
Office / nonfacility
Unavailable
Facility
$1522.82
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 63275 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
7,051
- Code
- 63275
- Physician work
- 25.21
- Practice expense
- 16.86
- Malpractice
- 9.78
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.21 | × 1.000 | 25.2100 |
| Practice expense | 16.86 | × 0.927 | 15.6292 |
| Malpractice | 9.78 | × 0.486 | 4.7531 |
| Total RVUs | 45.5923 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$1522.82
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.21 | 1 |
| Practice expense | 16.86 | 0.927 |
| Malpractice | 9.78 | 0.486 |
(25.21 × 1 + 16.86 × 0.927 + 9.78 × 0.486) × $33.4009 = $1522.82
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
63275 billing questions
How is this code distinguished from 63280?
This code describes a cervical lesion outside the dura. Code 63280 is for a lesion within the dura at the cervical level.
Does the lesion have to be removed, or can the surgeon biopsy it?
Biopsy, excision, or both may support this code when the operative service and cervical extradural location are documented.
What operative documentation supports the code?
Document the cervical level, the lesion's position outside the dura, the surgical exposure, and whether tissue was sampled, removed, or both.
Should modifier 50 be reported?
No. Modifier 50 is inappropriate for this cervical service.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard 50% multiple-procedure reduction to the other procedures.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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.
7,04863271,,Excise intrspinl lesion thrc,A,,29.17,19.03,NA,19.03,,12.05,60.25,60.25,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04963272,,Excise intrspinl lesion lmbr,A,,26.81,17.42,NA,17.42,,10.54,54.77,54.77,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05063273,,Excise intrspinl lesion scrl,A,,25.81,18.09,NA,18.09,,10.90,54.80,54.80,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05163275,,Bx/exc xdrl spine lesn crvl,A,,25.21,16.86,NA,16.86,,9.78,51.85,51.85,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05263276,,Bx/exc xdrl spine lesn thrc,A,,25.05,16.84,NA,16.84,,9.82,51.71,51.71,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05363277,,Bx/exc xdrl spine lesn lmbr,A,,21.83,15.06,NA,15.06,,8.09,44.98,44.98,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05463278,,Bx/exc xdrl spine lesn scrl,A,,21.57,16.60,NA,16.60,,9.12,47.29,47.29,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915