No office rate
Use 63005 for the corresponding one- or two-segment laminectomy in the lumbar region. Use 63011 when the treated segments are sacral.
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CMS RVU26D · Effective 2026-10-01
63011 Sacral laminectomy Medicare reimbursement rates in Virginia
Sacral laminectomy for one or two vertebral segments is reported when posterior bone removal explores or decompresses the sacral canal or cauda equina. Compare 63011 office and facility rates across CMS payment localities in Virginia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 63011 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$965.05–$1117.63
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Spine surgery
About 63011: Sacral laminectomy, one or two segments
Sacral laminectomy for one or two vertebral segments is reported when posterior bone removal explores or decompresses the sacral canal or cauda equina.
The surgeon removes posterior sacral bone to expose the spinal canal for exploration or decompression of the cauda equina. This code describes work at one or two sacral vertebral segments, without decompression by facet removal, foraminal enlargement, or disc removal. Neurosurgeons and orthopedic spine surgeons typically perform the procedure in a hospital operating room for conditions affecting the sacral canal or cauda equina.
Select the code by the treated spinal region and number of vertebral segments, not by the incision length or number of sides. The operative report should identify the sacral levels and describe the bone removal and the decompression or exploration performed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed 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 not appropriate. An assistant at surgery may be paid, and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 63011
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.51 · 51%
- Practice expense (office) RVU10.72 · 35%
- Malpractice RVU4.03 · 13%
200
Medicare services in 2024 · #4331 by national volume
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.
63011 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Code 63012 describes lumbar work involving removal of facets in a spondylolisthesis context. This code describes sacral laminectomy without that facet-removal approach.
No office rate
Code 63017 describes a lumbar laminectomy spanning more than two segments. This code is for one or two sacral segments.
No office rate
Code 63030 describes lumbar laminotomy for nerve-root decompression. This code describes sacral laminectomy for canal or cauda equina exploration or decompression.
Compare 63011 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1117.63
Virginia →
Office / nonfacility
Unavailable
Facility
$965.05
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63011 billing questions
How is this code different from 63005?
This code is for one or two sacral vertebral segments. Code 63005 describes the corresponding laminectomy service in the lumbar region.
Can this code be reported when the surgeon also removes a facet or disc?
The service described here excludes decompression by facetectomy, foraminotomy, or discectomy. Review the operative work and applicable coding rules before reporting another procedure for additional work.
Should modifier 50 be used for bilateral sacral decompression?
No. Modifier 50 is not appropriate for this code; the CMS descriptor and anatomy do not support a bilateral adjustment.
What documentation supports reporting one or two segments?
The operative report should identify the sacral level or levels treated and describe the laminectomy and the exploration or decompression performed.
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.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid, and co-surgeons are permitted. Team surgery 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,98863001,,Remove spine lamina 1/2 crvl,A,,17.17,12.12,NA,12.12,,6.45,35.74,35.74,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,98963003,,Remove spine lamina 1/2 thrc,A,,17.30,12.11,NA,12.11,,6.46,35.87,35.87,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,99063005,,Remove spine lamina 1/2 lmbr,A,,16.02,13.56,NA,13.56,,6.12,35.70,35.70,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,99163011,,Remove spine lamina 1/2 scrl,A,,15.51,10.72,NA,10.72,,4.03,30.26,30.26,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,99263012,,Remove lamina/facets lumbar,A,,16.43,12.37,NA,12.37,,5.62,34.42,34.42,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,99363015,,Remove spine lamina >2 crvcl,A,,20.33,15.08,NA,15.08,,7.84,43.25,43.25,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,99463016,,Remove spine lamina >2 thrc,A,,21.48,14.39,NA,14.39,,7.94,43.81,43.81,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00