Billing code 63304: Spinal lesion surgeryMedicare rate & RVUs in Ohio
Report cervical vertebral body resection performed to reach and remove an intraspinal lesion located within the dura at one segment.
CMS doesn’t publish an office rate for 63304 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 63304 covers
This code describes partial or complete removal of a cervical vertebral body as part of surgery to excise an intraspinal lesion within the dura. A neurosurgeon typically performs the operation in a hospital operating room. The vertebral resection provides access to the lesion; the intradural location distinguishes this service from the corresponding cervical procedure for a lesion outside the dura.
Select the code based on the cervical site, intradural location, and number of segments treated. The operative report should identify the lesion’s relationship to the dura, the cervical segment or segments involved, and the vertebral resection performed. Use the additional-segment code 63308 when another segment is treated. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted. Modifier 50 is inappropriate for this code.
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.
63304 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $2,222.91 |
How the 63304 rate is calculated
Each of 63304’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 · 63304
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 33.00Practice expense 21.37Malpractice 13.93
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63304
63304 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63304
Spinal lesion surgery
| 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 · 63304
Spinal lesion surgery
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
63304 without 51 · national facility
$2,281.28
Spinal lesion surgery
63304-51 · Second procedure: 50%
$1,140.64
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%).
63304 compared with similar codes
Compare codes
63304 vs 63300 vs 63305 vs 63308: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63300Vertebral resection
- The anatomic site is cervical in both codes; the lesion’s relationship to the dura determines the choice. Use 63304 for an intradural lesion and 63300 for an extradural lesion.
- 63305Vertebral resection
- Both describe intradural lesion surgery with vertebral body resection, but 63305 is for the thoracic region rather than the cervical region.
- 63308Vertebral resection
- 63304 represents the initial segment. Code 63308 is the add-on for each additional segment, not a substitute for the initial-segment code.
63304 billing questions
How is this distinguished from 63300?
Both involve cervical vertebral body resection for an intraspinal lesion. Choose 63304 when the lesion is intradural; 63300 describes the extradural situation.
When is 63308 reported with this service?
Report 63308 for each additional segment treated when the work extends beyond the initial segment. The operative note should identify the additional segment or segments.
Can modifier 50 be used?
No. Modifier 50 is inappropriate for this cervical vertebral procedure.
Are the preoperative visit and follow-up separately included?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
How are multiple procedures handled in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.
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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