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See a sample rate comparisonCPT 63047 Fee Schedule
Medicare rates as of October 2026
CPT 63047 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
Lam Facetec Foramot Lumbar, 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
| 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 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $1,065.49 national non-facility rate (2026) · View Medicare rates for 63047 |
| Medicaid Fee Schedule | $830.03 median of the 8 states in the free preview · View Medicaid rates for 63047 |
National average reimbursement for CPT 63047 by major payers:
$1,419.18
BCBS / Anthem
$1,520.33
UnitedHealthcare
$1,660.94
Aetna
$1,814.71
Cigna
Compare published rates across providers.
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CPT 63047
5 of 25 sample ratesHigher to lower in this preview
Kazimierz Komperda
$5,666.02Published rateMilford Marchant
$2,970.26Published rateKathleen Grier
$2,227.78Published rateMichael O'Malley
$1,652.81Published rateAzriel Benaroya
$978.57Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 63047 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 63047. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 63046-CPT | High | Lam Facetec Foramot Thrc, 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 | Lam Facetec Foramot Lumbar, 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 | Lam Facetec Foramot Ea Addl, 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 |
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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Frequently Asked Questions
A CPT (Current Procedural Terminology) code is a five-digit number used by medical professionals to report medical, surgical, and diagnostic procedures and services to entities such as health insurance companies. These codes are crucial for billing and reimbursement processes.
To find the cost of a specific medical procedure, especially considering your specific location, you should use a tool designed for price transparency. You can utilize Payerprice's fee schedule lookup tool. It allows you to search with a CPT code and your specific location to get an estimate of costs. It's also advisable to contact your insurance provider directly, as your out-of-pocket cost will depend on your specific plan, deductible, and co-insurance.
Medical costs can vary significantly due to several factors, including the specific healthcare provider (e.g., hospital vs. independent clinic, in-network vs. out-of-network), geographical location, the complexity of the procedure, negotiation power between providers and insurance companies, and whether the service is emergent or elective. Your insurance coverage also plays a huge role in the final out-of-pocket cost.
CPT (Current Procedural Terminology) codes describe the services and procedures performed by healthcare providers (e.g., an appendectomy, an office visit). ICD-10 (International Classification of Diseases, Tenth Revision) codes, on the other hand, describe the diagnosis or medical condition (e.g., acute appendicitis). Both types of codes are used together on medical claims to provide a complete picture of the patient's visit: what was done (CPT) and why it was done (ICD-10).
To get an estimate for a procedure before having it, first ask your healthcare provider for the CPT code(s) for the anticipated procedure. Then, use a price transparency tool like Payerprice's fee schedule lookup tool to search with the CPT code and your specific location for estimated costs. Additionally, contact your insurance company directly. They can provide an estimate based on your specific plan benefits, deductible status, and whether the provider is in-network.