Billing code 63275: Spinal lesion surgeryMedicare rate & RVUs in Oregon
Reports operative biopsy or removal of a lesion outside the dura in the cervical spinal canal, typically through posterior bony exposure.
CMS doesn’t publish an office rate for 63275 in Oregon.
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 63275 covers
A neurosurgeon uses posterior bony exposure of the cervical spine to reach a lesion in the spinal canal but outside the dura. The service may involve obtaining tissue for diagnosis, removing the lesion, or both. A typical situation is an epidural mass identified on imaging and approached surgically for tissue sampling or removal.
Select the code based on the cervical location, extradural compartment, and work documented—not simply the eventual pathology result. The operative report should describe the exposure, lesion location relative to the dura, and whether biopsy, excision, or both were performed. This major surgery includes 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 50% reduction. Modifier 50 is inappropriate for this cervical service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment 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.
Where 63275 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,724.19 |
| Rest Of Oregon | Unavailable | $1,632.57 |
How the 63275 rate is calculated
Each of 63275’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 · 63275
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 25.21Practice expense 16.86Malpractice 9.78
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63275
63275 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63275
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 · 63275
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
63275 without 51 · national facility
$1,731.84
Spinal lesion surgery
63275-51 · Second procedure: 50%
$865.92
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%).
63275 compared with similar codes
Compare codes
63275 vs 63276 vs 63280 vs 63270 vs 63265: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63276Spinal lesion surgery
- The operative approach is for an extradural lesion in either case; 63276 identifies the thoracic level, while 63275 identifies the cervical level.
- 63280Spinal tumor surgery
- Both concern a cervical intraspinal lesion, but 63275 is for a lesion outside the dura and 63280 for one within it.
- 63270Spinal lesion excision
- Consider 63270 for excision of a cervical extradural intraspinal neoplasm. Code 63275 describes biopsy or excision of an extradural lesion.
- 63265Spinal lesion removal
- Code 63265 describes excision or evacuation of a cervical extradural lesion other than a neoplasm; 63275 describes biopsy or excision.
63275 billing questions
How is this code distinguished from 63280?
This code describes a cervical lesion outside the dura. Code 63280 is for a lesion within the dura at the cervical level.
Does the lesion have to be removed, or can the surgeon biopsy it?
Biopsy, excision, or both may support this code when the operative service and cervical extradural location are documented.
What operative documentation supports the code?
Document the cervical level, the lesion's position outside the dura, the surgical exposure, and whether tissue was sampled, removed, or both.
Should modifier 50 be reported?
No. Modifier 50 is inappropriate for this cervical service.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard 50% multiple-procedure reduction to the other procedures.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery payment 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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