Billing code 63281: Spinal lesion surgeryMedicare rate & RVUs in Texas
Reports thoracic spinal surgery to biopsy or remove a lesion located inside the dura, including intradural extramedullary tumors such as meningiomas or schwannomas.
CMS doesn’t publish an office rate for 63281 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 63281 covers
A neurosurgeon uses a posterior approach, commonly with laminectomy or laminoplasty and opening of the dura, to obtain tissue from or remove a lesion within the thoracic spinal canal. Typical cases include an intradural extramedullary meningioma or schwannoma. The code identifies the thoracic location and intradural compartment; it is not the code for a lesion outside the dura or within the spinal cord substance. These procedures are generally performed in a hospital operating room.
Select the code when the operative report supports both the thoracic level and the lesion’s intradural location, and describes whether the surgeon biopsied or excised it. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy.
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 63281 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 | $2,040.39 |
| Beaumont | Unavailable | $1,957.93 |
| Brazoria | Unavailable | $1,958.68 |
| Dallas | Unavailable | $1,994.75 |
| Fort Worth | Unavailable | $1,993.42 |
| Galveston | Unavailable | $1,979.56 |
| Houston | Unavailable | $2,202.87 |
| Rest Of Texas | Unavailable | $1,973.17 |
How the 63281 rate is calculated
Each of 63281’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 · 63281
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 29.24Practice expense 19.83Malpractice 12.20
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63281
63281 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63281
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 · 63281
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
63281 without 51 · national facility
$2,046.47
Spinal lesion surgery
63281-51 · Second procedure: 50%
$1,023.24
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%).
63281 compared with similar codes
Compare codes
63281 vs 63276 vs 63286 vs 63280: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63276Spinal lesion surgery
- Use 63281 for an intradural thoracic lesion; 63276 describes a thoracic lesion approached in the extradural compartment.
- 63286Spinal lesion surgery
- Use 63281 for an intradural lesion outside the cord substance. Code 63286 is for an intradural lesion within the spinal cord.
- 63280Spinal tumor surgery
- Both address intradural spinal lesions, but 63280 is for the cervical region and 63281 is for the thoracic region.
63281 billing questions
How does this differ from code 63276?
This code is for a lesion inside the dura at a thoracic level. Code 63276 describes the extradural approach to a thoracic spinal lesion.
How does this differ from code 63286?
Code 63286 is for an intradural lesion within the spinal cord substance. This code identifies an intradural lesion outside the cord substance.
Can the code be reported for biopsy or excision?
It covers the thoracic intradural lesion service when the surgeon biopsies the lesion or removes it. The operative report should make the procedure and lesion location clear.
Can modifier 50 be used for bilateral thoracic lesions?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code’s descriptor and anatomy.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. An assistant at surgery may be paid; co-surgeons require 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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