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See a sample rate comparisonCPT 63030 Fee Schedule
Medicare rates as of October 2026
CPT 63030 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
Laminotomy (Hemilaminectomy), Laminotomy (Hemilaminectomy) With Decompression Of Nerve Root(S) Including Partial Facetectomy Foraminotomy Andor Excision Of Herniated Intervertebral Disc Including Open And Endoscopically-Assis
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | $898.15 national non-facility rate (2026) · View Medicare rates for 63030 |
| Medicaid Fee Schedule | $729.265 median of the 8 states in the free preview · View Medicaid rates for 63030 |
National average reimbursement for CPT 63030 by major payers:
$1,268.23
BCBS / Anthem
$1,327.30
UnitedHealthcare
$1,451.05
Aetna
$1,553.18
Cigna
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CPT 63030
5 of 25 sample ratesHigher to lower in this preview
Texas Orthopedics Surgery Center, LLC, Texas Orthopedics Surgery Center Limited Partnership, Ll
Texas Orthopedics Surgery Center LLC
$8,394.00Published rateUrology Surgery Center Lp
$3,712.00Published rateWilliam Vandecar
$1,962.08Published rateCameron Clarke
$1,309.79Published rateIowa Endoscopy Center, Inc.
Iowa Endoscopy Center Inc
$683.00Published rate
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See a sample payer proposalCPT 63030 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 63030. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 63020-CPT | High | Laminotomy (Hemilaminectomy) With Decompression Of Nerve Root(S) Including Partial Facetectomy Foraminotomy And/Or Excision Of Herniated Intervertebral Disk Including Open And Endoscopically- Assisted Approaches; 1 Interspace Cervical |
| 63030-CPT | High | Laminotomy (Hemilaminectomy), Laminotomy (Hemilaminectomy) With Decompression Of Nerve Root(S) Including Partial Facetectomy Foraminotomy Andor Excision Of Herniated Intervertebral Disc Including Open And Endoscopically-Assis |
| 63035-CPT | Moderate | Spinal Disk Surgery Add On, Laminotomy Hemilaminectomy With Decompression Of Nerve Root S Including Partial Facetectomy Foraminotomy And Or Excision Of Herniated Intervertebral Disc Each Additional Interspace Cervical Or Lumbar List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63030. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63030 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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Frequently Asked Questions
To find out the estimated cost of a specific medical procedure, you can utilize tools that provide fee schedule lookups. For detailed and accurate information based on CPT codes and your specific location, we recommend checking with services like Payerprice, which offers a comprehensive fee schedule lookup tool. You can also contact your healthcare provider's billing department for an estimate or your insurance company to understand your potential out-of-pocket costs based on your plan benefits.
CPT stands for Current Procedural Terminology. CPT codes are a standardized set of medical codes used by healthcare professionals and payers to describe medical, surgical, and diagnostic services. They are crucial for accurate billing and reimbursement. Understanding the CPT code for a service allows you to look up its typical cost using tools like Payerprice's fee schedule lookup, which provides pricing based on CPT codes and location.
Medical procedure prices can vary significantly due to several factors, including the healthcare provider's negotiated rates with different insurance companies, the type of facility (e.g., hospital vs. independent clinic), geographic location, and the specific services included in the procedure. To get an idea of expected costs in your area, you can use a tool like Payerprice, which allows you to search fee schedules by CPT code and location to compare potential prices.
If you receive an unexpected or high medical bill, first, carefully review it for any errors and compare it with your Explanation of Benefits (EOB) from your insurance company. If you have questions or concerns about the charges, contact your provider's billing department to discuss payment options, financial assistance, or dispute inaccuracies. To verify the typical costs for the billed services, you can use a resource like Payerprice's fee schedule lookup, providing the CPT codes and your location for comparison.
To compare prices for medical services from different providers, you'll need the specific CPT codes for the services you're interested in. Once you have these codes, you can use cost transparency tools designed for this purpose. Payerprice offers a fee schedule lookup tool where you can enter CPT codes and your specific location to find typical prices, helping you make informed decisions about your healthcare.