No office rate
Both address non-neoplastic lesions at the sacral level. Choose 63273 for a lesion inside the dura and 63268 for one outside it.
On this page
CMS RVU26D · Effective 2026-10-01
63273 Spinal lesion surgery Medicare reimbursement rates in Kentucky
Reports laminectomy-based removal or evacuation of a non-neoplastic lesion within the dura at the sacral level. Compare 63273 office and facility rates across CMS payment localities in Kentucky.
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 63273 in Kentucky?
Kentucky 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
$1732.35
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 63273: Sacral intradural lesion excision
Reports laminectomy-based removal or evacuation of a non-neoplastic lesion within the dura at the sacral level.
This service involves a sacral laminectomy to reach and remove or evacuate a non-neoplastic lesion located inside the dura. A neurosurgeon or spine surgeon typically performs it in an operating room. An intradural arachnoid cyst is one example; the operative record must establish both the sacral location and intradural position. This code is not for an intraspinal neoplasm.
Select the code based on the lesion’s non-neoplastic status, intradural location, and sacral level. The report should describe the lesion, its location relative to the dura, and the work performed. The laminectomy exposure is part of the service. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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 and team surgery are not permitted.
CMS billing rules for 63273
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU25.81 · 47%
- Practice expense (office) RVU18.09 · 33%
- Malpractice RVU10.90 · 20%
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.
63273 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
This is the corresponding non-neoplastic intradural lesion service at the lumbar level; 63273 is for the sacral level.
No office rate
This code is for a sacral intradural neoplasm requiring biopsy or excision. Code 63273 describes treatment of a non-neoplastic intradural lesion.
No office rate
This code addresses a sacral extradural neoplasm. Code 63273 is for a non-neoplastic lesion inside the dura.
Compare 63273 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$1732.35
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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 63273 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,050
- Code
- 63273
- Physician work
- 25.81
- Practice expense
- 18.09
- Malpractice
- 10.90
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.81 | × 1.000 | 25.8100 |
| Practice expense | 18.09 | × 0.889 | 16.0820 |
| Malpractice | 10.90 | × 0.915 | 9.9735 |
| Total RVUs | 51.8655 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$1732.35
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.81 | 1 |
| Practice expense | 18.09 | 0.889 |
| Malpractice | 10.9 | 0.915 |
(25.81 × 1 + 18.09 × 0.889 + 10.9 × 0.915) × $33.4009 = $1732.35
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.
63273 billing questions
How does this differ from code 63268?
Both describe treatment of a non-neoplastic lesion at the sacral level. This code is for an intradural lesion; 63268 is for an extradural lesion.
Can this code be used for an intradural tumor?
No. This code is for a non-neoplastic lesion. Code selection for an intradural neoplasm depends on its location and other operative details.
Is the laminectomy reported separately?
The laminectomy exposure used to reach the lesion is part of this service and should not be unbundled as a separate access procedure.
Should modifier 50 be added for bilateral work?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What assistant and global-surgery rules apply?
An assistant at surgery may be paid, but co-surgeons and team surgery are not permitted. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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.
7,04763270,,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
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
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631