Billing code 63267: Spinal lesion excisionMedicare rate & RVUs in Ohio

Reported for lumbar laminectomy to remove or evacuate a non-neoplastic lesion outside the dura, such as an epidural abscess or hematoma.

CMS RVU26DEffective Oct 1, 20261 payment locality11.1K Medicare services in 2024

CMS doesn’t publish an office rate for 63267 in Ohio.

—Office (non-facility)
$1,283.99Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 63267 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 63267 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 63267 covers

A neurosurgeon or orthopedic spine surgeon uses a lumbar laminectomy to reach and remove or evacuate a lesion in the spinal canal but outside the dura. Typical clinical examples include an extradural abscess or hematoma when surgical removal or evacuation is performed. The service is generally provided in an operating room, with the operative report identifying the lumbar level and the lesion’s extradural location.

Choose this code when the treated lesion is non-neoplastic and extradural; a different code applies when the lesion is intradural or a neoplasm. Documentation should support the approach, site, compartment, and work performed. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care through day 90. 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% reduction. Assistant-at-surgery payment may be allowed; 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.

63267 in Ohio

63267 office and facility rates by payment locality
Payment localityOfficeFacility
OhioUnavailable$1,283.99

How the 63267 rate is calculated

Each of 63267’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 · 63267

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 18.96Practice expense 13.93Malpractice 6.71

39.6000 adjusted RVUs×$33.4009 conversion factor=$1,322.68

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 63267

63267 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63267

Spinal lesion excision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 63267

Spinal lesion excision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

63267 without 51 · national facility

$1,322.68

Spinal lesion excision

63267-51 · Second procedure: 50%

$661.34

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%).

When to use modifier 51

63267 compared with similar codes

Compare codes

63267 vs 63272 vs 63277 vs 63282 vs 63266: national Medicare rates

Swap in your local Medicare rate.

  • 63267
    Spinal lesion excision · 18.96 wRVU
    —
  • 63272
    Spinal lesion surgery · 26.81 wRVU
    —
  • 63277
    Spinal lesion surgery · 21.83 wRVU
    —
  • 63282
    Spinal lesion surgery · 27.45 wRVU
    —
  • 63266
    Spinal lesion excision · 24.06 wRVU
    —

How to choose

63272Spinal lesion surgery
Both concern non-neoplastic lumbar lesions, but 63272 is for a lesion inside the dura and outside the spinal cord; this code is for an extradural lesion.
63277Spinal lesion surgery
Both involve lumbar extradural lesions, but 63277 is used for a neoplasm. This code is for a non-neoplastic lesion.
63282Spinal lesion surgery
Code 63282 concerns an intradural, extramedullary neoplasm at the lumbar level. This code concerns a non-neoplastic lesion outside the dura.
63266Spinal lesion excision
The lesion type and extradural location are comparable, but 63266 applies at the thoracic level rather than the lumbar level.

63267 billing questions

How is this code distinguished from 63272?

This code is for a non-neoplastic lesion outside the dura. Code 63272 is for a non-neoplastic lesion inside the dura but outside the spinal cord.

Can this code be used for a lumbar spinal tumor?

No. This code is for a non-neoplastic extradural lesion; a code for an extradural neoplasm is the relevant comparison when the lesion is a tumor.

What documentation supports the code?

The operative report should identify the lumbar level, establish that the lesion was extradural and non-neoplastic, and describe the removal or evacuation performed through the laminectomy.

How does the global period affect postoperative billing?

Medicare includes the day-before preoperative visit and related postoperative care through day 90 in the major-surgery global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be allowed. 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
RVUs for 63267PPRRVU2026_Oct_nonQPP.csv, line 7,045 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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