No office rate
63185 concerns a spinal nerve procedure with limited segment involvement. Use 63191 when the spinal accessory nerve is the operative target.
On this page
CMS RVU26D · Effective 2026-10-01
63191 Nerve incision Medicare reimbursement rates in Ohio
Reports operative incision or division of the spinal accessory nerve, including selected procedures for severe cervical dystonia when that nerve is the surgical target. Compare 63191 office and facility rates across CMS payment localities in Ohio.
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 63191 in Ohio?
Ohio 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
$1335.27
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Neurosurgery
About 63191: Spinal accessory nerve incision
Reports operative incision or division of the spinal accessory nerve, including selected procedures for severe cervical dystonia when that nerve is the surgical target.
The surgeon exposes and incises or divides the spinal accessory nerve as the intended neural target. A neurosurgeon or other surgeon qualified to perform the procedure may use it in selected cases of severe cervical dystonia or spasmodic torticollis. The operative report should identify the spinal accessory nerve and describe the surgical work performed; procedures on spinal nerve roots or spinal cord tracts involve different targets.
Report 63191 when the documented operation is directed at the spinal accessory nerve, not simply because another cervical nerve procedure was performed. Record the indication, laterality, nerve treated, and operative details supporting the service. Medicare assigns 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 other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63191
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU18.45 · 45%
- Practice expense (office) RVU15.00 · 36%
- Malpractice RVU7.77 · 19%
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.
63191 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
63190 concerns a spinal nerve procedure involving more than two segments. It is not the code for incision of the spinal accessory nerve.
No office rate
63170 involves incision of spinal cord tracts. Choose 63191 when the documented target is the spinal accessory nerve instead.
Compare 63191 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
Ohio →
Office / nonfacility
Unavailable
Facility
$1335.27
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 63191 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
7,037
- Code
- 63191
- Physician work
- 18.45
- Practice expense
- 15.00
- Malpractice
- 7.77
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.45 | × 1.000 | 18.4500 |
| Practice expense | 15.00 | × 0.913 | 13.6950 |
| Malpractice | 7.77 | × 1.008 | 7.8322 |
| Total RVUs | 39.9772 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1335.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.45 | 1 |
| Practice expense | 15 | 0.913 |
| Malpractice | 7.77 | 1.008 |
(18.45 × 1 + 15 × 0.913 + 7.77 × 1.008) × $33.4009 = $1335.27
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.
63191 billing questions
How does 63191 differ from spinal nerve root incision codes?
63191 targets the spinal accessory nerve. Codes 63185 and 63190 concern spinal nerve procedures distinguished by the extent or segment involvement.
Is this code appropriate for every operation for cervical dystonia?
No. Report it when the spinal accessory nerve is the nerve surgically incised or divided; a different operative target calls for its own code.
Can modifier 50 be used for bilateral treatment?
CMS identifies this as a bilateral procedure. Bilateral reporting with modifier 50 is paid at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
May an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. 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.
7,03463173,,Drainage of spinal cyst,A,,23.70,17.09,NA,17.09,,10.02,50.81,50.81,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03563185,,Incise spine nrv half segmnt,A,,16.08,14.17,NA,14.17,,6.77,37.02,37.02,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03663190,,Incise spine nrv >2 segmnts,A,,18.42,11.34,NA,11.34,,3.92,33.68,33.68,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03763191,,Incise spine accessory nerve,A,,18.45,15.00,NA,15.00,,7.77,41.22,41.22,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03863197,,Lam w/cordotomy 1stg thrc,A,,23.48,17.01,NA,17.01,,9.92,50.41,50.41,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,03963200,,Release spinal cord lumbar,A,,20.90,16.33,NA,16.33,,8.73,45.96,45.96,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,04063250,,Revise spinal cord vsls crvl,A,,42.76,24.05,NA,24.05,,18.05,84.86,84.86,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703