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See a sample rate comparisonCPT 63011 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Remove Spine Lamina 1 2 Scrl, Laminectomy With Exploration And Or Decompression Of Spinal Cord And Or Cauda Equina Without Facetectomy Foraminotomy Or Discectomy Eg Spinal Stenosis 1 Or 2 Vertebral Segments Sacral
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63011 |
| Medicaid Fee Schedule | View Medicaid rates for 63011 |
National average reimbursement for CPT 63011 by major payers:
$1,356.52
$1,481.75
$1,558.59
$1,777.04
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CPT 63011
5 of 25 sample ratesHigher to lower in this preview
Deaconess Hospital, Inc, <Unavail>
Deaconess Hospital Inc
$13,127.00Published rateChristus Santa Rosa Outpatient Surgery, Christus Physicians Surgery Center - San Marcos
$6,168.00Published rateBaptist And Physicians Outpatient Surgery Center Of North Ms, Lp, Oxford Surgery Center
Baptist And Physicians Outpatient Surgery Center Of North Ms Lp
$3,550.00Published rateCarlin Vision Surgery Center LLC
$2,462.00Published rateUpstate Gastroenterology, LLC
Upstate Gastroenterology LLC
$1,521.00Published rate
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See a sample payer proposalCPT 63011 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63011 code is part of the Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 63011 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 63005-CPT | High | Remove Spine Lamina 1 2 Lmbr, Laminectomy With Exploration And Or Decompression Of Spinal Cord And Or Cauda Equina Without Facetectomy Foraminotomy Or Discectomy Eg Spinal Stenosis 1 Or 2 Vertebral Segments Lumbar Except For Spondylolisthesis |
| 63011-CPT | High | Remove Spine Lamina 1 2 Scrl, Laminectomy With Exploration And Or Decompression Of Spinal Cord And Or Cauda Equina Without Facetectomy Foraminotomy Or Discectomy Eg Spinal Stenosis 1 Or 2 Vertebral Segments Sacral |
| 63012-CPT | High | Remove Lamina/Facets Lumbar, Laminectomy With Removal Of Abnormal Facets And/Or Pars Inter-Articularis With Decompression Of Cauda Equina And Nerve Roots For Spondylolisthesis Lumbar (Gill Type Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63011 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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