CPT 63047 Fee Schedule
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.
| 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 • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63047 |
National average reimbursement for CPT 63047 by major payers:
$1,419.18
$1,520.33
$1,660.94
$1,862.11
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 63047 | ||||||
United | 63047 | $2390.82 | 1720596653 - MICHAEL HOLMBOE | 840405257 | AZ | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $2492.97 | 1760914840 - ERIC SECRIST | 911606533 | WA | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $1287.82 | 1427286699 - RYAN WILKINS | 161608040 | NY | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 63047 | $5666.02 | 1487079810 - KAZIMIERZ KOMPERDA | 611661781 | NY | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 63047 | $1260.46 | 1285809848 - ANANT KUMAR MD ORTHOPEDICS AND SPINE SURGERY PC | 262268935 | CO | Orthopaedic Surgery of the Spine Physician (207XS0117X) |
United | 63047 | $3902.54 | 1972605681 - ROBERT BRUCE | 582619196 | GA | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $2689.66 | 1912961319 - JEFFREY RODGERS | 420984558 | IA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 63047 | $1652.81 | 1295393031 - RUSSELL STEWART | 540506332 | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $2160.84 | 1104115542 - JUSTIN COLANESE | 351151025 | IN | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $2322.67 | 1568782829 - ISAAC FEHRENBACHER | 351159676 | IN | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $3121.20 | 1689069577 - PATRICK KENNEDY | 61755234 | PA | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $4906.58 | 1891177150 - ZACHARY MEYER | 430653611 | MO | Pediatric Orthopaedic Surgery Physician (207XP3100X) |
United | 63047 | $1360.05 | 1588906945 - ALEXANDER LAMPLEY | 593696338 | FL | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $1823.78 | 1659710093 - MICHAEL KNIGHT | 540506332 | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 63047 | $2970.26 | 1013185867 - MILFORD MARCHANT | 461322238 | MD | Orthopaedic Surgery Physician (207X00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 63047 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63047 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 63047 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 |
|---|---|---|
| 63046-CPT | High | Laminectomy, Facetectomy And Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord, Cauda Equina And/Or Nerve Root(S), (Eg, Spinal Or Lateral Recess Stenosis)), Single Vertebral Segment; Thoracic |
| 63047-CPT | High | Laminectomy, Facetectomy And Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord, Cauda Equina And/Or Nerve Root(S), (Eg, Spinal Or Lateral Recess Stenosis)), Single Vertebral Segment; Lumbar |
| 63048-CPT | Moderate | Laminectomy Facetectomy And Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord Cauda Equina And/Or Nerve Root[S] (Eg Spinal Or Lateral Recess Stenosis]) Single Vertebral Segment; Each Additional Vertebral Segment Cervical Thoracic Or Lumbar (List Separately In Addition To Code For Primary Procedure) (Desc Rvsd 1/1/22) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63047. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63047 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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