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See a sample rate comparisonCPT 63016 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 2 Thrc, Laminectomy With Exploration And Or Decompression Of Spinal Cord And Or Cauda Equina Without Facetectomy Foraminotomy Or Discectomy Eg Spinal Stenosis More Than 2 Vertebral Segments Thoracic
| 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 AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63016 |
| Medicaid Fee Schedule | View Medicaid rates for 63016 |
National average reimbursement for CPT 63016 by major payers:
$1,915.88
$2,070.90
$2,226.47
$2,457.28
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CPT 63016
5 of 25 sample ratesHigher to lower in this preview
St. Clair Memorial Hospital
St Clair Health Corporation
$21,685.69Published rateOutpatient Women'S And Children'S Surgery Center, Ltd
Outpatient Womens And Childrens Surgery Center Ltd
$6,046.00Published rateChippenham Ambulatory Surgery Center, LLC
Chippenham Ambulatory Surgery Center LLC
$4,443.00Published rateAthens Surgery Center LLC, The Surgery Center Of Athens
$2,585.00Published rateMid-Bronx Endoscopy Center LLC
Midbronx Endoscopy Center LLC
$530.00Published rate
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See a sample payer proposalCPT 63016 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63016 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 63016 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 |
|---|---|---|
| 63015-CPT | High | Remove Spine Lamina 2 Crvcl, Laminectomy With Exploration And Or Decompression Of Spinal Cord And Or Cauda Equina Without Facetectomy Foraminotomy Or Discectomy Eg Spinal Stenosis More Than 2 Vertebral Segments Cervical |
| 63016-CPT | High | Remove Spine Lamina 2 Thrc, Laminectomy With Exploration And Or Decompression Of Spinal Cord And Or Cauda Equina Without Facetectomy Foraminotomy Or Discectomy Eg Spinal Stenosis More Than 2 Vertebral Segments Thoracic |
| 63017-CPT | High | Remove Spine Lamina 2 Lmbr, Laminectomy With Exploration And Or Decompression Of Spinal Cord And Or Cauda Equina Without Facetectomy Foraminotomy Or Discectomy Eg Spinal Stenosis More Than 2 Vertebral Segments Lumbar |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63016 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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