No office rate
Choose 63064 for a costovertebral approach to thoracic decompression; choose 63055 when the surgeon uses a transpedicular approach.
On this page
CMS RVU26D · Effective 2026-10-01
63064 Spinal decompression Medicare reimbursement rates in Massachusetts
Reports decompression of the spinal cord or nerve root at one thoracic segment when the surgeon uses a costovertebral approach. Compare 63064 office and facility rates across CMS payment localities in Massachusetts.
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 63064 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1664.41–$1788.23
2 of 2 localities have a supported rate.
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.
Thoracic spine surgery
About 63064: Thoracic costovertebral spinal cord decompression
Reports decompression of the spinal cord or nerve root at one thoracic segment when the surgeon uses a costovertebral approach.
This service involves reaching a thoracic spinal lesion through a costovertebral exposure and decompressing the spinal cord or nerve root at one segment. The surgeon may remove bone or address a herniated thoracic disk as part of the decompression. Spine surgeons, including orthopedic surgeons and neurosurgeons, typically perform it in a hospital or other facility operating room.
Select the code when the documented approach is costovertebral and the work treats one thoracic segment; identify the level, pathology, approach, and decompression performed. For additional segments, CPT add-on code 63066 may be reported with this primary procedure when its requirements are met. The 90-day global period includes the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 63064
- 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 RVU25.56 · 51%
- Practice expense (office) RVU15.66 · 31%
- Malpractice RVU9.25 · 18%
180
Medicare services in 2024 · #4424 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.
63064 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
63064 represents the primary thoracic segment. Code 63066 is the add-on for each additional segment treated through the costovertebral approach.
No office rate
63046 describes thoracic laminectomy, facetectomy, and foraminotomy decompression. Use 63064 when the documented operation uses the costovertebral approach.
No office rate
63077 describes thoracic disk surgery through a different approach; 63064 is selected for costovertebral spinal cord or nerve-root decompression.
Compare 63064 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$1788.23
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$1664.41
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63064 billing questions
How does this differ from 63055?
Both describe thoracic spinal cord decompression, but 63064 uses a costovertebral approach. Code 63055 is for a transpedicular approach.
Can 63066 be reported with 63064?
CPT add-on code 63066 may be reported for an additional thoracic segment treated through the costovertebral approach. Documentation should establish the additional level and work.
Is disk removal separately reported?
Disk removal performed as part of the decompression is included in this service. Do not separately report another procedure for the same disk work.
Should modifier 50 be used for bilateral work?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
What documentation supports code selection?
Document the thoracic level, the costovertebral approach, the condition treated, and the decompression performed. If additional segments are treated, identify each one.
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.
7,01263055,,Decompress spinal cord thrc,A,,22.96,14.98,NA,14.98,,8.56,46.50,46.50,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01363056,,Decompress spinal cord lmbr,A,,21.31,13.59,NA,13.59,,7.16,42.06,42.06,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01463057,,Decompress spine cord add-on,A,,5.12,1.73,NA,1.73,,1.76,8.61,8.61,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01563064,,Decompress spinal cord thrc,A,,25.56,15.66,NA,15.66,,9.25,50.47,50.47,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01663066,,Decompress spine cord add-on,A,,3.18,1.11,NA,1.11,,1.33,5.62,5.62,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01763075,,Neck spine disk surgery,A,,19.11,13.12,NA,13.12,,6.34,38.57,38.57,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01863076,,Neck spine disk surgery,A,,3.94,1.30,NA,1.30,,1.26,6.50,6.50,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00