No office rate
Both address thoracic intradural neoplasms, but 63281 is for a lesion outside the spinal cord; 63286 is for one within the cord.
On this page
CMS RVU26D · Effective 2026-10-01
63286 Spinal lesion surgery Medicare reimbursement rates in Indiana
Reports a thoracic laminectomy to biopsy or remove a neoplasm located inside the dura and within the spinal cord itself. Compare 63286 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 63286 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
$2175.03
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 63286: Thoracic intramedullary spinal lesion biopsy or excision
Reports a thoracic laminectomy to biopsy or remove a neoplasm located inside the dura and within the spinal cord itself.
A neurosurgeon uses a laminectomy to reach a thoracic spinal cord lesion, opens the dura, and obtains a biopsy or removes the lesion. The code distinguishes a lesion within the cord from one that is extradural or inside the dura but outside the cord. These operations are generally performed in a hospital operating room; the operative report should establish the thoracic level, the lesion’s relationship to the dura and cord, and whether tissue was sampled or removed.
Report this code for the thoracic intradural, intramedullary neoplasm procedure, rather than selecting by the amount of tissue removed alone. The laminectomy and exposure are part of the service. The code has 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 procedure is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 63286
- 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 RVU36.68 · 49%
- Practice expense (office) RVU22.61 · 30%
- Malpractice RVU15.39 · 21%
115
Medicare services in 2024 · #4773 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.
63286 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
63276 applies to a thoracic extradural neoplasm. Choose 63286 when the lesion is intradural and intramedullary.
No office rate
The lesion compartment and procedure are similar, but 63285 is for the cervical level rather than the thoracic level.
No office rate
This sibling code is for the thoracolumbar level; 63286 identifies the thoracic level.
Compare 63286 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
$2175.03
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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 63286 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
7,060
- Code
- 63286
- Physician work
- 36.68
- Practice expense
- 22.61
- Malpractice
- 15.39
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 36.68 | × 1.000 | 36.6800 |
| Practice expense | 22.61 | × 0.927 | 20.9595 |
| Malpractice | 15.39 | × 0.486 | 7.4795 |
| Total RVUs | 65.1190 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$2175.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 36.68 | 1 |
| Practice expense | 22.61 | 0.927 |
| Malpractice | 15.39 | 0.486 |
(36.68 × 1 + 22.61 × 0.927 + 15.39 × 0.486) × $33.4009 = $2175.03
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.
63286 billing questions
How is this code distinguished from the thoracic extramedullary code?
Use this code when the lesion is within the spinal cord. A lesion inside the dura but outside the cord is extramedullary and points to 63281.
Does the laminectomy have a separate code?
The laminectomy provides access for the biopsy or excision represented by this service; it is not separately reported as a separate access procedure for the same operation.
What documentation supports code selection?
Document the thoracic level, that the lesion is intradural and within the cord, and whether the surgeon performed a biopsy, excision, or both.
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.
Can modifier 50 be used for a lesion on one side of the cord?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the 90-day global affect postoperative services?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
7,05763282,,Bx/exc idrl spine lesn lmbr,A,,27.45,19.16,NA,19.16,,11.41,58.02,58.02,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05863283,,Bx/exc idrl spine lesn scrl,A,,26.09,18.95,NA,18.95,,11.02,56.06,56.06,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05963285,,Bx/exc idrl imed lesn cervl,A,,37.10,22.81,NA,22.81,,15.66,75.57,75.57,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,06063286,,Bx/exc idrl imed lesn thrc,A,,36.68,22.61,NA,22.61,,15.39,74.68,74.68,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,06163287,,Bx/exc idrl imed lesn thrlmb,A,,39.08,23.50,NA,23.50,,16.49,79.07,79.07,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,06263290,,Bx/exc xdrl/idrl lsn any lvl,A,,39.80,23.76,NA,23.76,,16.81,80.37,80.37,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,06363295,,Repair laminectomy defect,A,,5.12,1.79,NA,1.79,,2.15,9.06,9.06,0,ZZZ,0.00,0.00,0.00,0,2,2,2,0,9,,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