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See a sample rate comparisonCPT 63040 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.
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 | None AS - PA/NP/CNS assistant at surgery 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63040 |
| Medicaid Fee Schedule | View Medicaid rates for 63040 |
National average reimbursement for CPT 63040 by major payers:
$1,915.27
$1,913.88
$1,982.74
$2,259.11
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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 CPT 63040 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 63040 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 |
|---|---|---|
| 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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