Billing code 63286: Spinal lesion surgeryMedicare rate & RVUs in Massachusetts
Reports a thoracic laminectomy to biopsy or remove a neoplasm located inside the dura and within the spinal cord itself.
CMS doesn’t publish an office rate for 63286 in Massachusetts.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 63286 covers
A neurosurgeon uses a laminectomy to reach a thoracic spinal cord lesion, opens the dura, and obtains a biopsy or removes the lesion. The code distinguishes a lesion within the cord from one that is extradural or inside the dura but outside the cord. These operations are generally performed in a hospital operating room; the operative report should establish the thoracic level, the lesion’s relationship to the dura and cord, and whether tissue was sampled or removed.
Report this code for the thoracic intradural, intramedullary neoplasm procedure, rather than selecting by the amount of tissue removed alone. The laminectomy and exposure are part of the service. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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 require supporting documentation, and team surgery is not permitted.
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.
Where 63286 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $2,634.57 |
| Rest Of Massachusetts | Unavailable | $2,449.66 |
How the 63286 rate is calculated
Each of 63286’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 63286
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 36.68Practice expense 22.61Malpractice 15.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63286
63286 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63286
Spinal lesion surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 63286
Spinal lesion surgery
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
63286 without 51 · national facility
$2,494.38
Spinal lesion surgery
63286-51 · Second procedure: 50%
$1,247.19
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
63286 compared with similar codes
Compare codes
63286 vs 63281 vs 63276 vs 63285 vs 63287: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63281Spinal lesion surgery
- Both address thoracic intradural neoplasms, but 63281 is for a lesion outside the spinal cord; 63286 is for one within the cord.
- 63276Spinal lesion surgery
- 63276 applies to a thoracic extradural neoplasm. Choose 63286 when the lesion is intradural and intramedullary.
- 63285Spinal cord lesion
- The lesion compartment and procedure are similar, but 63285 is for the cervical level rather than the thoracic level.
- 63287Spinal lesion surgery
- This sibling code is for the thoracolumbar level; 63286 identifies the thoracic level.
63286 billing questions
How is this code distinguished from the thoracic extramedullary code?
Use this code when the lesion is within the spinal cord. A lesion inside the dura but outside the cord is extramedullary and points to 63281.
Does the laminectomy have a separate code?
The laminectomy provides access for the biopsy or excision represented by this service; it is not separately reported as a separate access procedure for the same operation.
What documentation supports code selection?
Document the thoracic level, that the lesion is intradural and within the cord, and whether the surgeon performed a biopsy, excision, or both.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Can modifier 50 be used for a lesion on one side of the cord?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the 90-day global affect postoperative services?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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