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See a sample rate comparisonCPT 63011 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
| 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 | 59 - Distinct Procedural Service 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | $1,010.71 national non-facility rate (2026) · View Medicare rates for 63011 |
| Medicaid Fee Schedule | $821.67 median of the 8 states in the free preview · View Medicaid rates for 63011 |
National average reimbursement for CPT 63011 by major payers:

$1,356.52
BCBS / Anthem

$1,481.75
UnitedHealthcare

$1,558.59
Aetna

$1,777.04
Cigna
Choose a payer to see a sample of rates for CPT 63011.
Deaconess Hospital, Inc, <Unavail>
Deaconess Hospital Inc
Christus Santa Rosa Outpatient Surgery, Christus Physicians Surgery Center - San Marcos
Baptist And Physicians Outpatient Surgery Center Of North Ms, Lp, Oxford Surgery Center
Baptist And Physicians Outpatient Surgery Center Of North Ms Lp
Carlin Vision Surgery Center LLC
Upstate Gastroenterology, LLC
Upstate Gastroenterology LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 63011 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 63011. Select one to see its fee schedule.
| 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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