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See a sample rate comparisonCPT 63040 Fee Schedule
Medicare rates as of October 2026
CPT 63040 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
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).
| 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 | AS - PA/NP/CNS assistant at surgery 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | $1,287.94 national non-facility rate (2026) · View Medicare rates for 63040 |
| Medicaid Fee Schedule | $1,056.235 median of the 8 states in the free preview · View Medicaid rates for 63040 |
National average reimbursement for CPT 63040 by major payers:
$1,915.27
BCBS / Anthem
$1,913.88
UnitedHealthcare
$1,982.74
Aetna
$2,259.11
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 63040.
CPT 63040
5 of 25 sample ratesHigher to lower in this preview
Mercy Hospitals East Communities, Mercy Outpatientsurgery Center Washington
Mercy Hospitals East Communities
$6,220.00Published rateAmbulatory Surgical Center At Basking Ridge
Liberty Corner Surgical Center LLC
$4,000.00Published rateSimi Valley Surgery Center Inc
$2,700.00Published rateRockville Eye Surgery Center, LLC, Palisades Eye Surgery Center
Palisades Eye Surgery Center
$1,639.00Published rateMiddletown Endoscopy Asc LLC, The Gi Endoscopy Center
Middletown Endoscopy Asc LLC
$1,039.00Published rate
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See a sample payer proposalCPT 63040 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 63040. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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). |
| 63042-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 63040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63040 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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