No office rate
Choose 63056 for a transpedicular approach to lumbar neural decompression at one segment. Code 63030 describes a laminotomy approach to lumbar nerve-root decompression.
On this page
CMS RVU26D · Effective 2026-10-01
63056 Spinal decompression Medicare reimbursement rates in Minnesota
Reports lumbar decompression performed through a transpedicular approach to relieve pressure on neural structures at one spinal segment. Compare 63056 office and facility rates across CMS payment localities in Minnesota.
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 63056 in Minnesota?
Minnesota 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
$1249.64
1 of 1 localities have a supported rate.
Payment area: Minnesota
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 63056: Lumbar transpedicular neural decompression
Reports lumbar decompression performed through a transpedicular approach to relieve pressure on neural structures at one spinal segment.
A spine surgeon uses a transpedicular route through a lumbar vertebra to reach and decompress neural structures, such as when a herniated disc or another extradural lesion is compressing them. The code describes work at one lumbar segment. This is an operative service, typically performed in a hospital or other surgical facility by an orthopedic spine surgeon or neurosurgeon.
Report the code when the operative documentation supports both the transpedicular approach and decompression at a single lumbar segment. Identify the treated level, compressive pathology, and work performed; a routine lumbar laminotomy or decompression by a different approach is not this service. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. When multiple 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. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63056
- 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 RVU21.31 · 51%
- Practice expense (office) RVU13.59 · 32%
- Malpractice RVU7.16 · 17%
6.7K
Medicare services in 2024 · #1683 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.
63056 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
Code 63047 describes lumbar decompression using laminectomy, facetectomy, and foraminotomy. It is distinct from the transpedicular approach represented by 63056.
No office rate
The two codes share the transpedicular decompression approach, but 63055 is for a thoracic segment and 63056 is for a lumbar segment.
No office rate
Code 63057 is for each additional qualifying segment; 63056 reports the primary lumbar segment.
Compare 63056 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
Minnesota →
Office / nonfacility
Unavailable
Facility
$1249.64
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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 63056 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
7,013
- Code
- 63056
- Physician work
- 21.31
- Practice expense
- 13.59
- Malpractice
- 7.16
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.31 | × 1.000 | 21.3100 |
| Practice expense | 13.59 | × 1.029 | 13.9841 |
| Malpractice | 7.16 | × 0.296 | 2.1194 |
| Total RVUs | 37.4135 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$1249.64
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.31 | 1 |
| Practice expense | 13.59 | 1.029 |
| Malpractice | 7.16 | 0.296 |
(21.31 × 1 + 13.59 × 1.029 + 7.16 × 0.296) × $33.4009 = $1249.64
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.
63056 billing questions
How does this differ from lumbar code 63030?
This code is for decompression through a transpedicular approach. Code 63030 describes lumbar nerve-root decompression through a laminotomy approach, often for a disc herniation.
When is code 63057 reported with this service?
Code 63057 describes decompression at each additional segment and may be reported when the surgeon performs the qualifying work at another segment. Document the additional level and work separately.
Can modifier 50 be used for this code?
No. The single-segment lumbar service is not reported as a bilateral procedure, so modifier 50 is inappropriate.
What documentation supports code 63056?
The operative report should identify the lumbar level, the transpedicular route, the compressive lesion, and the neural decompression performed.
Are the related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. The day-before preoperative visit is also included.
Can an assistant surgeon or co-surgeon be paid?
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.
7,01063052,,Lam facetc/frmt arthrd lum 1,A,,4.14,1.39,NA,1.39,,1.35,6.88,6.88,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01163053,,Lam factc/frmt arthrd lum ea,A,,3.69,1.23,NA,1.23,,1.21,6.13,6.13,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002