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See a sample rate comparisonCPT 63043 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.
Laminotomy Addl Cervical, Laminotomy Hemilaminectomy With Decompression Of Nerve Root S Including Partial Facetectomy Foraminotomy And Or Excision Of Herniated Intervertebral Disc Reexploration Single Interspace Each Additional Cervical Interspace 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 | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 63043 |
| Medicaid Fee Schedule | View Medicaid rates for 63043 |
National average reimbursement for CPT 63043 by major payers:
$530.75
$442.74
$771.67
$760.75
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CPT 63043
5 of 25 sample ratesHigher to lower in this preview
Lexington Health Inc, Lmc Northeast Asc
Lexington Health Inc
$6,632.00Published rateAdvanced Surgery Center Of Bethesda, LLC
Asc Bethesda
$3,570.00Published rateNew Lexington Clinic Psc, Dermatology Associates Of Kentucky Psc
New Lexington Clinic, P.S.C.
$2,074.00Published rateBel Air Ambulatory Surgical Center ,L.L.C.
Bel Air Ambulatory Surgical Center LLC
$1,128.00Published rateUmesh Jairath
Deaconess Hospital Inc
$450.60Published rate
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See a sample payer proposalCPT 63043 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63043 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 63043 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 |
|---|---|---|
| 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). |
| 63043-CPT | Moderate | Laminotomy Addl Cervical, Laminotomy Hemilaminectomy With Decompression Of Nerve Root S Including Partial Facetectomy Foraminotomy And Or Excision Of Herniated Intervertebral Disc Reexploration Single Interspace Each Additional Cervical Interspace List Separately In Addition To Code For Primary Procedure |
| 63044-CPT | Moderate | Laminotomy Addl Lumbar, Laminotomy Hemilaminectomy With Decompression Of Nerve Root S Including Partial Facetectomy Foraminotomy And Or Excision Of Herniated Intervertebral Disc Reexploration Single Interspace Each Additional Lumbar Interspace 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 63043. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63043 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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