Billing code 63012: Lumbar decompressionMedicare rate & RVUs in Ohio
Reports single-segment lumbar decompression for spondylolisthesis when abnormal facets or pars are removed to free the cauda equina and nerve roots.
CMS doesn’t publish an office rate for 63012 in Ohio.
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 63012 covers
63012 represents decompression at one lumbar vertebral segment for spondylolisthesis. The surgeon removes abnormal posterior elements, such as facets and/or the pars interarticularis, to free the cauda equina and nerve roots. This is associated with a Gill-type decompression for a slipped vertebra, rather than a routine lumbar stenosis laminectomy. Orthopedic spine surgeons and neurosurgeons typically perform it in an operating room at a hospital or ambulatory surgery center.
The operative report should identify the lumbar segment, spondylolisthesis, abnormal structures removed, and neural decompression performed. The bone removal and nerve-root decompression are part of this service. CMS classifies it as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment and co-surgeons are permitted; 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.
63012 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,115.21 |
How the 63012 rate is calculated
Each of 63012’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 · 63012
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.43Practice expense 12.37Malpractice 5.62
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63012
63012 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63012
Lumbar decompression
| 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) | 2 | Permitted. |
| 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 · 63012
Lumbar decompression
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
63012 without 51 · national facility
$1,149.66
Lumbar decompression
63012-51 · Second procedure: 50%
$574.83
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%).
63012 compared with similar codes
Compare codes
63012 vs 63005 vs 63017 vs 63047 vs 63030: national Medicare rates
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How to choose
- 63005Lumbar laminectomy
- 63005 describes lumbar stenosis decompression at one or two segments, with spondylolisthesis excluded. 63012 is specific to single-segment spondylolisthesis with removal of abnormal facets and/or pars.
- 63017Lumbar laminectomy
- 63017 is for lumbar stenosis decompression over more than two segments, except for spondylolisthesis. 63012 is limited to one segment and addresses spondylolisthesis.
- 63047Lumbar decompression
- 63047 describes single-segment lumbar decompression for stenosis. Choose 63012 when the operative service is the spondylolisthesis-specific removal of abnormal facets and/or pars.
- 63030Lumbar decompression
- 63030 is for lumbar nerve-root decompression for a disc herniation. 63012 addresses single-segment decompression for spondylolisthesis with abnormal facet or pars removal.
63012 billing questions
When should I choose 63012 instead of 63047?
Use 63012 for single-segment lumbar decompression for spondylolisthesis involving removal of abnormal facets and/or pars. Use 63047 for lumbar stenosis decompression when its service description, rather than the spondylolisthesis-specific service, matches the operation.
Can the decompression steps be billed separately?
The abnormal facet or pars removal and neural decompression are integral to 63012. Do not separately report those same steps as another decompression service at that segment.
Should modifier 50 be appended for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code, even when the operative work involves both sides.
What documentation supports 63012?
Document the lumbar vertebral segment, the spondylolisthesis, which abnormal posterior elements were removed, and the cauda equina or nerve-root decompression performed.
How does the 90-day global affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery 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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