CPT code 63285: Spinal cord lesion2026 Medicare rate & RVUs in Iowa
Reports cervical laminectomy to biopsy or remove a neoplasm located within the spinal cord, beneath the dura.
CMS doesn’t publish an office rate for 63285 in Iowa.
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 63285 covers
This service involves a posterior cervical laminectomy to reach an intradural, intramedullary neoplasm—one located within the spinal cord itself. The surgeon opens the dura to obtain a diagnostic tissue sample or remove the lesion. A neurosurgeon typically performs the operation in a hospital operating room; the code applies to the cervical region, not a lesion outside the dura or one in the surrounding space within the dura.
Select the code based on the documented cervical location and the lesion’s intramedullary position, rather than the biopsy-versus-removal intent alone. The operative report should identify the level, the lesion’s relationship to the dura and spinal cord, and whether tissue was sampled or the lesion was removed. Medicare assigns 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%. An assistant 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.
63285 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | Unavailable | $2,143.94 |
How the 63285 rate is calculated
Each of 63285’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 · 63285
RVUs × geographic indexes × conversion factor
Work37.10
37.10 RVUs× 1.000 GPCI
Practice expense22.81
22.81 RVUs× 1.000 GPCI
Malpractice15.66
15.66 RVUs× 1.000 GPCI
Adjusted RVUs
75.5700
Conversion factor
$33.4009
Medicare rate
$2,524.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63285
63285 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63285
Spinal cord lesion
| 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 · 63285
Spinal cord lesion
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
63285 without 51 · national facility
$2,524.11
Spinal cord lesion
63285-51 · Second procedure: 50%
$1,262.06
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%).
63285 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 63280Spinal tumor surgery
- Both address cervical intradural lesions, but 63285 is for a lesion within the spinal cord; 63280 is for one outside the cord.
- 63275Spinal lesion surgery
- Use 63275 when the cervical neoplasm is extradural. Code 63285 requires an intradural, intramedullary location.
- 63286Spinal lesion surgery
- The lesion compartment and biopsy-or-excision service are similar, but 63286 is for the thoracic region rather than the cervical region.
63285 billing questions
How is this distinguished from code 63280?
Use 63285 for a lesion within the spinal cord. Code 63280 describes a cervical intradural lesion outside the cord.
Does this code cover biopsy as well as removal?
Yes. The code covers the cervical laminectomy service for biopsy or excision of an intradural, intramedullary neoplasm.
What operative documentation supports this code?
Document the cervical level, the lesion’s intradural and intramedullary location, and whether the surgeon sampled or removed it.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does Medicare handle other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
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
Fee sheets
Put 63285 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →