No office rate
Use 63301 for a thoracic extradural lesion; use 63305 when the lesion is intradural. The operative report should support the lesion's relationship to the dura.
On this page
CMS RVU26D · Effective 2026-10-01
63305 Vertebral resection Medicare reimbursement rates in Kentucky
Reports thoracic vertebral body resection performed to remove or access an intradural spinal lesion when that level and lesion location match the service. Compare 63305 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 63305 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
$2295.24
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.
Spinal surgery
About 63305: Thoracic intradural lesion vertebral resection
Reports thoracic vertebral body resection performed to remove or access an intradural spinal lesion when that level and lesion location match the service.
This major spine operation removes part or all of a thoracic vertebral body as part of treating an intraspinal lesion located within the dura. Neurosurgeons and orthopedic spine surgeons may perform it in a hospital operating room, often for an intradural tumor such as a meningioma or schwannoma when vertebral body resection is part of the operative approach. The code is specific to the thoracic region and the intradural location; it does not describe an ordinary vertebral body tumor resection.
Select the code from the documented lesion location and spinal region, and retain the operative report describing the lesion and vertebral resection. The 90-day global period includes the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is not appropriate for this service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63305
- 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 RVU35.33 · 49%
- Practice expense (office) RVU22.19 · 31%
- Malpractice RVU14.93 · 21%
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.
63305 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
63304 describes the intradural service in the cervical region. 63305 is for the thoracic region.
No office rate
63306 is for the thoracolumbar region, while 63305 is limited to the thoracic region.
No office rate
63308 is an add-on for an additional vertebral segment, not the primary thoracic intradural lesion service reported by 63305.
Compare 63305 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
$2295.24
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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 63305 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,069
- Code
- 63305
- Physician work
- 35.33
- Practice expense
- 22.19
- Malpractice
- 14.93
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.33 | × 1.000 | 35.3300 |
| Practice expense | 22.19 | × 0.889 | 19.7269 |
| Malpractice | 14.93 | × 0.915 | 13.6609 |
| Total RVUs | 68.7179 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$2295.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.33 | 1 |
| Practice expense | 22.19 | 0.889 |
| Malpractice | 14.93 | 0.915 |
(35.33 × 1 + 22.19 × 0.889 + 14.93 × 0.915) × $33.4009 = $2295.24
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.
63305 billing questions
How does this differ from 63301?
Both codes are for the thoracic region, but 63305 addresses an intradural lesion and 63301 an extradural lesion. The operative documentation should establish which side of the dura contains the lesion.
When would 63308 be reported with 63305?
63308 is an add-on for each additional vertebral segment when the requirements for that additional resection are met. The operative report should identify the additional segment; it is not a replacement for the primary code.
Can modifier 50 be used?
No. This code describes work at the thoracic spine, not a paired left-and-right service, so modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
7,06663302,,Remove vert xdrl body thrlmb,A,,30.37,20.45,NA,20.45,,12.83,63.65,63.65,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,06763303,,Remov vert xdrl bdy lmbr/sac,A,,32.71,20.51,NA,20.51,,13.82,67.04,67.04,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,06863304,,Remove vert idrl body crvcl,A,,33.00,21.37,NA,21.37,,13.93,68.30,68.30,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,06963305,,Remove vert idrl body thrc,A,,35.33,22.19,NA,22.19,,14.93,72.45,72.45,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,07063306,,Remov vert idrl bdy thrclmbr,A,,34.66,21.95,NA,21.95,,14.64,71.25,71.25,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,07163307,,Remov vert idrl bdy lmbr/sac,A,,34.09,21.14,NA,21.14,,14.39,69.62,69.62,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,07263308,,Remove vertebral body add-on,A,,5.11,1.71,NA,1.71,,1.83,8.65,8.65,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,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