63005 Lumbar laminectomy Medicare reimbursement rates in Pennsylvania

A spine surgeon removes lumbar lamina to enlarge the spinal canal and relieve compression of neural structures such as the cauda equina. The service may be performed for lumbar canal stenosis or to remove a spinal extradural lesion. It is an operative decompression, typically performed in a hospital operating room, rather than a limited laminotomy directed at a single nerve root.

Select this code when the documented laminectomy covers one or two lumbar vertebral segments and the work does not include the facetectomy, foraminotomy, or discectomy described by other procedure codes. The operative report should identify the lumbar levels, the decompression performed, and any additional work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral adjustment does not apply. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not.