Billing code 63250: Spinal AVM surgeryMedicare rate & RVUs in Texas
Reports cervical-level surgery to remove or occlude a spinal cord arteriovenous malformation through a laminectomy approach.
CMS doesn’t publish an office rate for 63250 in Texas.
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 63250 covers
This code describes operative treatment of an arteriovenous malformation involving the spinal cord at a cervical level, using a laminectomy approach to expose and remove or occlude the abnormal vessels. Neurosurgeons typically perform the procedure in a hospital operating room, often with microsurgical techniques. The operative report should establish the vascular malformation, the cervical location, and the treatment performed.
Select this code for the cervical spinal level; thoracic and thoracolumbar locations have separate sibling codes. The service has 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 others at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require 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.
Where 63250 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $2,815.12 |
| Beaumont | Unavailable | $2,719.30 |
| Brazoria | Unavailable | $2,705.96 |
| Dallas | Unavailable | $2,758.43 |
| Fort Worth | Unavailable | $2,758.24 |
| Galveston | Unavailable | $2,736.51 |
| Houston | Unavailable | $3,066.89 |
| Rest Of Texas | Unavailable | $2,734.95 |
How the 63250 rate is calculated
Each of 63250’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 · 63250
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 42.76Practice expense 24.05Malpractice 18.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63250
63250 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63250
Spinal AVM 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 · 63250
Spinal AVM 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
63250 without 51 · national facility
$2,834.40
Spinal AVM surgery
63250-51 · Second procedure: 50%
$1,417.20
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%).
63250 compared with similar codes
Compare codes
63250 vs 63251 vs 63252 vs 63270: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63251Spinal vascular surgery
- Use 63251 when the treated spinal cord arteriovenous malformation is at the thoracic level; this code is for the cervical level.
- 63252Spinal vascular surgery
- Use 63252 for the thoracolumbar level. This code identifies cervical-level treatment.
- 63270Spinal lesion excision
- Code 63270 describes excision of an intramedullary cervical spinal lesion, rather than the excision or occlusion of a spinal cord arteriovenous malformation.
63250 billing questions
How do I distinguish this code from 63251 or 63252?
Use this code for a cervical spinal cord arteriovenous malformation. Code 63251 identifies the thoracic level, and 63252 identifies the thoracolumbar level.
Does this code describe excision of any cervical spinal lesion?
No. It describes operative treatment of a spinal cord arteriovenous malformation. Other intraspinal lesion excision codes describe different lesion types or procedures.
What documentation supports this code?
The operative report should identify the arteriovenous malformation, its cervical location, and whether it was removed or occluded through the operative approach.
Can modifier 50 be used for bilateral treatment?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for its descriptor and anatomy.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
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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