Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 63035 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 63035 |
| Medicaid Fee Schedule | View Medicaid rates for 63035 |
National average reimbursement for CPT 63035 by major payers:
$309.33
$273.61
$327.44
$348.24
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 63035.
CPT 63035
5 of 25 sample ratesHigher to lower in this preview
Surgicare Of La Veta Inc., Barranca Surgery Center
$7,995.00Published rateMemorial Hermann Surgery Center, Memorial Hermann Surgery Center, The Woodlands
Memorial Hermann Surgery Center
$1,831.00Published ratePhysicians Surgery Center At Good Samaritan, LLC, Good Samaritan Surgery Center
Physicians Surgery Center At Good Samaritan LLC
$663.00Published rateLutherville Surgery Center, LLC
Lutherville Surgery Center LLC
$181.00Published rateThe Eye Surgical Center Of Fort Wayne, LLC
The Eye Surgical Center Of Fort Wayne LLC
$68.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 63035 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63035 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 63035 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 |
|---|---|---|
| 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 |
| 63040-CPT | High | Surgery For Pinched Nerve, Additional Surgery To Relieve Pressure On A Nerve In The Spine. The Surgery May Include The Removal Of Part Of A Spine Bone (Vertebra) And/Or The Removal Of A Bulging Disc (The Cushion Between The Vertebra). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63035 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 63035) and we'll show you how you compare in 15 minutes or less.