No office rate
Both address non-neoplastic lumbar lesions, but 63267 is for an extradural lesion; this code is for an intradural lesion.
On this page
CMS RVU26D · Effective 2026-10-01
63272 Spinal lesion surgery Medicare reimbursement rates in Kansas
Reports lumbar surgery to remove or evacuate a non-neoplastic lesion within the dura, such as an intradural cyst or collection. Compare 63272 office and facility rates across CMS payment localities in Kansas.
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 63272 in Kansas?
Kansas 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
$1598.90
1 of 1 localities have a supported rate.
Payment area: Kansas
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 63272: Lumbar intradural lesion excision
Reports lumbar surgery to remove or evacuate a non-neoplastic lesion within the dura, such as an intradural cyst or collection.
A neurosurgeon or spine surgeon uses a lumbar approach to open the spinal canal and remove or evacuate a lesion located within the dura that is not a neoplasm. Examples may include an intradural cyst or a collection requiring evacuation. The operative report should establish the lumbar level, the lesion’s intradural location, and the work performed; the code is not selected for a neoplasm or an extradural lesion.
Report this code when the documented procedure and lesion location support that service, rather than a code for a different spinal region or compartment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63272
- 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 RVU26.81 · 49%
- Practice expense (office) RVU17.42 · 32%
- Malpractice RVU10.54 · 19%
132
Medicare services in 2024 · #4653 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.
63272 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Code 63282 is for biopsy or excision of an intradural, extramedullary neoplasm at a lumbar level. This code applies to a non-neoplastic lesion.
No office rate
Code 63277 addresses a lumbar extradural neoplasm. This code is for a non-neoplastic lesion located within the dura.
Compare 63272 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
Kansas →
Office / nonfacility
Unavailable
Facility
$1598.90
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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 63272 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
7,049
- Code
- 63272
- Physician work
- 26.81
- Practice expense
- 17.42
- Malpractice
- 10.54
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 26.81 | × 1.000 | 26.8100 |
| Practice expense | 17.42 | × 0.904 | 15.7477 |
| Malpractice | 10.54 | × 0.504 | 5.3122 |
| Total RVUs | 47.8698 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$1598.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 26.81 | 1 |
| Practice expense | 17.42 | 0.904 |
| Malpractice | 10.54 | 0.504 |
(26.81 × 1 + 17.42 × 0.904 + 10.54 × 0.504) × $33.4009 = $1598.90
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.
63272 billing questions
How does this differ from 63267?
This code is for a non-neoplastic lesion within the dura at a lumbar level. Code 63267 describes the corresponding non-neoplastic service for an extradural lesion.
Can this code be used for a spinal tumor?
No. This code is for a non-neoplastic lesion. A tumor requires the code that matches its location and the documented tumor procedure.
What documentation supports reporting this code?
The operative report should identify the lumbar level, document that the lesion was intradural and non-neoplastic, and describe its removal or evacuation.
Is modifier 50 appropriate for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to 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 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.
7,04663268,,Excise intrspinl lesion scrl,A,,19.52,15.88,NA,15.88,,8.24,43.64,43.64,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04763270,,Excise intrspinl lesion crvl,A,,29.06,19.23,NA,19.23,,12.28,60.57,60.57,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04863271,,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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958