No office rate
63090 is the primary lumbar vertebral body removal and decompression procedure. 63091 is reported for an additional lumbar segment during that procedure.
On this page
CMS RVU26D · Effective 2026-10-01
63091 Vertebral body removal Medicare reimbursement rates in Massachusetts
Reports removal of an additional lumbar vertebral segment for spinal cord or nerve root decompression after the primary lumbar vertebral body procedure. Compare 63091 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 63091 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
$155.45–$164.93
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.
Spinal surgery
About 63091: Additional lumbar vertebral body removal
Reports removal of an additional lumbar vertebral segment for spinal cord or nerve root decompression after the primary lumbar vertebral body procedure.
This add-on describes removal of another lumbar vertebral body segment through an anterior approach as part of decompression of the spinal cord or nerve roots. A spine surgeon or neurosurgeon may perform the work in a hospital operating room for conditions requiring decompression at multiple lumbar levels. The code represents an additional segment, not a separate primary operation or removal of additional bone within the same segment.
Report 63091 only with the primary lumbar procedure, 63090. The operative report should identify the lumbar levels treated, the additional vertebral segment removed, the anterior approach, and the decompression performed. CMS classifies 63091 as an add-on code, so it is billed with a primary procedure and paid within that procedure’s global period.
CMS billing rules for 63091
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU2.95 · 62%
- Practice expense (office) RVU0.93 · 20%
- Malpractice RVU0.85 · 18%
515
Medicare services in 2024 · #3540 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.
63091 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
63088 describes an additional vertebral segment in the thoracolumbar region. 63091 is the additional-segment code for the lumbar region.
No office rate
63056 describes lumbar decompression through a transpedicular approach. 63091 is for removal of an additional lumbar vertebral segment through an anterior approach with decompression.
Compare 63091 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
$164.93
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$155.45
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63091 billing questions
Can 63091 be reported by itself?
No. It is an add-on code and is reported with the primary lumbar vertebral body removal procedure, 63090.
How is 63091 different from 63090?
63090 reports the primary lumbar vertebral segment removal. Use 63091 for an additional lumbar vertebral segment treated during the procedure.
What should the operative report document?
Document the anterior approach, decompression, and each lumbar vertebral segment removed, including which segment is additional to the primary level.
How are units determined?
Report the additional segment or segments treated, rather than counting bone fragments or separate pieces removed from one segment.
How does 63091 differ from 63088?
Both describe an additional vertebral segment removal, but 63091 is for the lumbar region; 63088 is for the thoracolumbar region.
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.
7,02563087,,Remov vertbr dcmprn thrclmbr,A,,36.59,19.06,NA,19.06,,12.14,67.79,67.79,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
7,02663088,,Remove vertebral body add-on,A,,4.21,1.37,NA,1.37,,1.44,7.02,7.02,0,ZZZ,0.00,0.00,0.00,0,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
7,02763090,,Remove vert body dcmprn lmbr,A,,30.16,15.66,NA,15.66,,8.73,54.55,54.55,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
7,02863091,,Remove vertebral body add-on,A,,2.95,0.93,NA,0.93,,0.85,4.73,4.73,0,ZZZ,0.00,0.00,0.00,0,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
7,02963101,,Remove vert body dcmprn thrc,A,,33.25,20.92,NA,20.92,,12.22,66.39,66.39,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03063102,,Remove vert body dcmprn lmbr,A,,33.25,20.28,NA,20.28,,11.56,65.09,65.09,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03163103,,Remove vertebral body add-on,A,,4.70,1.58,NA,1.58,,1.59,7.87,7.87,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00