No office rate
Use 63052 for additional decompression performed during posterior interbody fusion. 63047 describes lumbar decompression outside that fusion-specific context.
On this page
CMS RVU26D · Effective 2026-10-01
63052 Spinal decompression Medicare reimbursement rates in Virginia
Reports additional lumbar nerve or spinal canal decompression performed at one segment during posterior interbody fusion for stenosis or related compression. Compare 63052 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 63052 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
$215.75–$250.62
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.
Spinal surgery
About 63052: Lumbar decompression during interbody fusion
Reports additional lumbar nerve or spinal canal decompression performed at one segment during posterior interbody fusion for stenosis or related compression.
This add-on describes a surgeon’s decompression of the lumbar canal, lateral recess, or nerve roots at one segment while performing posterior interbody fusion. The work may involve removing bone or other compressive tissue to relieve stenosis or nerve compression. It is used when decompression goes beyond the work needed to access and prepare the disc space for fusion, rather than for routine fusion exposure alone.
Report 63052 with the applicable primary posterior interbody arthrodesis service, such as 22630 or 22633. The operative report should identify the lumbar segment, the compression being treated, and the additional decompression performed. Medicare treats 63052 as an add-on: it is billed only with a primary procedure and paid within that procedure’s global period. For an additional decompressed segment, consider the related add-on code 63053 when its requirements are met.
CMS billing rules for 63052
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.14 · 60%
- Practice expense (office) RVU1.39 · 20%
- Malpractice RVU1.35 · 20%
48.8K
Medicare services in 2024 · #786 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.
63052 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
63052 covers one lumbar segment; 63053 is the add-on for each additional decompressed segment during posterior interbody arthrodesis.
No office rate
22630 reports the posterior interbody fusion itself. 63052 reports qualifying additional decompression at one segment and is not a stand-alone fusion code.
Compare 63052 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
$250.62
Virginia →
Office / nonfacility
Unavailable
Facility
$215.75
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63052 billing questions
Can 63052 be billed by itself?
No. It is an add-on and must be reported with a qualifying primary posterior interbody arthrodesis procedure.
What distinguishes 63052 from 63047?
63052 is for additional decompression performed during posterior interbody fusion. 63047 describes lumbar decompression outside that specific fusion context.
Does routine work to prepare the disc space support 63052?
No. The record should support additional decompression for neural or canal compression beyond the work needed to access and prepare the space for fusion.
When is 63053 used with 63052?
63053 is the related add-on for decompression at each additional segment. Document the separate level and decompressive work.
What documentation supports reporting 63052?
Document the lumbar segment, the source of compression, and the decompression performed in addition to the posterior interbody fusion work.
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.
7,00763048,,Lam facetec &foramot ea addl,A,,3.38,1.13,NA,1.13,,1.10,5.61,5.61,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,00863050,,Cervical laminoplsty 2/> seg,A,,21.46,13.64,NA,13.64,,6.85,41.95,41.95,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,00963051,,C-laminoplasty w/graft/plate,A,,24.87,14.73,NA,14.73,,7.55,47.15,47.15,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01063052,,Lam facetc/frmt arthrd lum 1,A,,4.14,1.39,NA,1.39,,1.35,6.88,6.88,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01163053,,Lam factc/frmt arthrd lum ea,A,,3.69,1.23,NA,1.23,,1.21,6.13,6.13,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01263055,,Decompress spinal cord thrc,A,,22.96,14.98,NA,14.98,,8.56,46.50,46.50,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,01363056,,Decompress spinal cord lmbr,A,,21.31,13.59,NA,13.59,,7.16,42.06,42.06,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00