Billing code 63265: Spinal lesion removalMedicare rate & RVUs in Minnesota
Reports cervical laminectomy to remove or evacuate a nonneoplastic lesion outside the dura, such as an epidural abscess or hematoma.
CMS doesn’t publish an office rate for 63265 in Minnesota.
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 63265 covers
A neurosurgeon or spine surgeon uses a cervical laminectomy to reach and remove or evacuate a lesion in the spinal canal but outside the dura. Typical situations include surgery for a cervical epidural abscess or hematoma. The lesion must be nonneoplastic; the code is not selected just because a lesion is found during a cervical spine operation. The operative report should establish the cervical level, extradural location, nonneoplastic nature, and removal or evacuation performed.
Report the service for the lesion operation, including the laminectomy exposure used to reach it, rather than separately coding that exposure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. A bilateral adjustment is not appropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
63265 in Minnesota
| Payment locality | Office | Facility |
|---|---|---|
| Minnesota | Unavailable | $1,417.55 |
How the 63265 rate is calculated
Each of 63265’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 · 63265
RVUs × geographic indexes × conversion factor
Work23.22
23.22 RVUs× 1.000 GPCI
Practice expense16.09
16.09 RVUs× 1.000 GPCI
Malpractice9.00
9.00 RVUs× 1.000 GPCI
Adjusted RVUs
48.3100
Conversion factor
$33.4009
Medicare rate
$1,613.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63265
63265 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63265
Spinal lesion removal
| 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 · 63265
Spinal lesion removal
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
63265 without 51 · national facility
$1,613.60
Spinal lesion removal
63265-51 · Second procedure: 50%
$806.80
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%).
63265 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 63270Spinal lesion excision
- Both concern nonneoplastic cervical spinal lesions, but this code is for an extradural lesion; 63270 is for an intradural, extramedullary lesion.
- 63275Spinal lesion surgery
- Use this code for a nonneoplastic extradural cervical lesion. Code 63275 is for biopsy or excision of a neoplastic extradural lesion.
- 63266Spinal lesion excision
- The lesion type and extradural location are comparable, but 63266 applies to the thoracic region rather than the cervical region.
63265 billing questions
How does this differ from code 63270?
This code is for a nonneoplastic lesion outside the dura. Code 63270 is for a nonneoplastic lesion inside the dura but outside the spinal cord.
When would code 63275 be used instead?
Code 63275 describes biopsy or excision of an extradural cervical spinal lesion when the lesion is neoplastic. This code is for a nonneoplastic extradural lesion.
Can the cervical laminectomy exposure be billed separately?
The laminectomy exposure used to reach and remove or evacuate the lesion is part of this operative service; do not separately report it for the same exposure.
Does modifier 50 apply to bilateral cervical levels?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
What documentation supports reporting this code?
Document the cervical site, that the lesion is extradural and nonneoplastic, and the removal or evacuation performed. The operative report should make the lesion compartment clear.
How are assistant and co-surgeon services handled?
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 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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