No office rate
Use 63281 for an intradural thoracic lesion; 63276 describes a thoracic lesion approached in the extradural compartment.
On this page
CMS RVU26D · Effective 2026-10-01
63281 Spinal lesion surgery Medicare reimbursement rates in Wyoming
Reports thoracic spinal surgery to biopsy or remove a lesion located inside the dura, including intradural extramedullary tumors such as meningiomas or schwannomas. Compare 63281 office and facility rates across CMS payment localities in Wyoming.
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 63281 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1940.53
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
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.
Neurosurgery
About 63281: Thoracic intradural spinal lesion surgery
Reports thoracic spinal surgery to biopsy or remove a lesion located inside the dura, including intradural extramedullary tumors such as meningiomas or schwannomas.
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.
CMS billing rules for 63281
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU29.24 · 48%
- Practice expense (office) RVU19.83 · 32%
- Malpractice RVU12.20 · 20%
705
Medicare services in 2024 · #3252 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.
63281 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Use 63281 for an intradural lesion outside the cord substance. Code 63286 is for an intradural lesion within the spinal cord.
No office rate
Both address intradural spinal lesions, but 63280 is for the cervical region and 63281 is for the thoracic region.
Compare 63281 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$1940.53
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 63281 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,056
- Code
- 63281
- Physician work
- 29.24
- Practice expense
- 19.83
- Malpractice
- 12.20
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.24 | × 1.000 | 29.2400 |
| Practice expense | 19.83 | × 1.000 | 19.8300 |
| Malpractice | 12.20 | × 0.740 | 9.0280 |
| Total RVUs | 58.0980 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1940.53
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 29.24 | 1 |
| Practice expense | 19.83 | 1 |
| Malpractice | 12.2 | 0.74 |
(29.24 × 1 + 19.83 × 1 + 12.2 × 0.74) × $33.4009 = $1940.53
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
7,05363277,,Bx/exc xdrl spine lesn lmbr,A,,21.83,15.06,NA,15.06,,8.09,44.98,44.98,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05463278,,Bx/exc xdrl spine lesn scrl,A,,21.57,16.60,NA,16.60,,9.12,47.29,47.29,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05563280,,Bx/exc idrl spine lesn crvl,A,,29.53,19.94,NA,19.94,,12.28,61.75,61.75,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05663281,,Bx/exc idrl spine lesn thrc,A,,29.24,19.83,NA,19.83,,12.20,61.27,61.27,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05763282,,Bx/exc idrl spine lesn lmbr,A,,27.45,19.16,NA,19.16,,11.41,58.02,58.02,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05863283,,Bx/exc idrl spine lesn scrl,A,,26.09,18.95,NA,18.95,,11.02,56.06,56.06,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,05963285,,Bx/exc idrl imed lesn cervl,A,,37.10,22.81,NA,22.81,,15.66,75.57,75.57,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,