No office rate
Choose 63040 for decompression of the spinal cord, cauda equina, and/or nerve roots at a cervical vertebral segment, such as for stenosis. Choose 63020 for nerve-root decompression defined by cervical interspace.
On this page
CMS RVU26D · Effective 2026-10-01
63040 Cervical laminotomy Medicare reimbursement rates in Iowa
Posterior cervical laminotomy decompresses the spinal cord and/or nerve roots at one vertebral segment, commonly for stenosis, and is reported by the operating spine surgeon. Compare 63040 office and facility rates across CMS payment localities in Iowa.
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 63040 in Iowa?
Iowa 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
$1128.27
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
Spine surgery
About 63040: Cervical single-segment laminotomy decompression
Posterior cervical laminotomy decompresses the spinal cord and/or nerve roots at one vertebral segment, commonly for stenosis, and is reported by the operating spine surgeon.
A spine surgeon performs a limited posterior opening through the cervical lamina to relieve compression of the spinal cord, cauda equina, and/or nerve roots at one vertebral segment. A typical clinical setting is operative treatment of cervical spinal stenosis. The work is defined by the decompression at that segment, rather than by the number of individual nerve roots addressed.
Report one unit for the single cervical segment treated, with the operative report identifying the level and the compressive condition addressed. Distinguish this service from a nerve-root-focused laminotomy reported by interspace and from a more extensive laminectomy with facetectomy and foraminotomy. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made, and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 63040
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.80 · 51%
- Practice expense (office) RVU12.61 · 33%
- Malpractice RVU6.15 · 16%
105
Medicare services in 2024 · #4846 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.
63040 compared with similar codes
Office rates for Iowa, from the same CMS release.
63043
No office rateLaminotomy addl cervical
63043 is an add-on for each additional cervical segment; it is not the code for the first segment. Report 63040 for the initial segment.
No office rate
63045 describes cervical laminectomy with facetectomy and foraminotomy. Use 63040 when the documented procedure is a laminotomy decompression at a single cervical segment.
No office rate
63042 is the lumbar single-segment counterpart. The cervical location distinguishes 63040.
Compare 63040 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
Iowa →
Office / nonfacility
Unavailable
Facility
$1128.27
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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 63040 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
7,000
- Code
- 63040
- Physician work
- 19.80
- Practice expense
- 12.61
- Malpractice
- 6.15
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.80 | × 1.000 | 19.8000 |
| Practice expense | 12.61 | × 0.915 | 11.5381 |
| Malpractice | 6.15 | × 0.397 | 2.4416 |
| Total RVUs | 33.7797 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1128.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.8 | 1 |
| Practice expense | 12.61 | 0.915 |
| Malpractice | 6.15 | 0.397 |
(19.8 × 1 + 12.61 × 0.915 + 6.15 × 0.397) × $33.4009 = $1128.27
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.
63040 billing questions
How is this different from 63020?
63040 describes decompression at a cervical vertebral segment for the spinal cord, cauda equina, and/or nerve roots, such as for stenosis. 63020 is the nerve-root decompression code reported by cervical interspace.
Can an additional cervical segment be reported?
When the surgeon decompresses another cervical segment in the same operative session, 63043 is the add-on code associated with 63040. The operative report should identify each treated segment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Those included services are not separately reported as routine follow-up care.
How is bilateral work reported?
CMS lists this as a bilateral procedure: modifier 50 is paid at 150%. The documentation should support decompression on both sides.
May an assistant or co-surgeon be reported?
CMS indicates that assistant-at-surgery payment may be made and co-surgeons are permitted. Team surgery is not permitted for this code.
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.
6,99763030,,Lamot dcmprn nrv rt 1 lmbr,A,,11.70,11.35,NA,11.35,,3.84,26.89,26.89,0,090,0.11,0.76,0.13,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,99863032,,Lamot rpr anulr dfct 1 lmbr,A,,2.50,0.79,NA,0.79,,0.79,4.08,4.08,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,99963035,,Lamot dcmprn nrv rt ea addl,A,,3.76,1.25,NA,1.25,,1.17,6.18,6.18,0,ZZZ,0.00,0.00,0.00,0,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,00063040,,Laminotomy single cervical,A,,19.80,12.61,NA,12.61,,6.15,38.56,38.56,0,090,0.11,0.76,0.13,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,00163042,,Laminotomy single lumbar,A,,18.29,12.73,NA,12.73,,5.50,36.52,36.52,0,090,0.11,0.76,0.13,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,00263043,,Laminotomy addl cervical,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,00363044,,Laminotomy addl lumbar,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136