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See a sample rate comparisonCPT 63052 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.
Lam Facetc Frmt Arthrd Lum 1, Laminectomy Facetectomy Or Foraminotomy Unilateral Or Bilateral With Decompression Of Spinal Cord Cauda Equina And Or Nerve Root S Eg Spinal Or Lateral Recess Stenosis During Posterior Interbody Arthrodesis Lumbar Single Vertebral Segment 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 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 63052 |
| Medicaid Fee Schedule | View Medicaid rates for 63052 |
National average reimbursement for CPT 63052 by major payers:
$326.34
$371.49
$364.77
$439.79
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CPT 63052
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes-Gi Diagnostics LLC
Saint Lukesgi Diagnostics LLC
$6,623.00Published rateSurgcenter Camelback LLC
$531.00Published rateSt. Charles Surgery Center
St. Charles Surgery Center, LLC
$196.00Published rateLapeer County Surgery Center LLC
Lapeer County Surgery Center L
$150.00Published rateThe Asc At Waugh Chapel
$43.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 63052 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63052 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 63052 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 |
|---|---|---|
| 63051-CPT | High | C Laminoplasty W Graft Plate, Laminoplasty Cervical With Decompression Of The Spinal Cord 2 Or More Vertebral Segments With Reconstruction Of The Posterior Bony Elements Including The Application Of Bridging Bone Graft And Non Segmental Fixation Devices Eg Wire Suture Mini Plates When Performed |
| 63052-CPT | Moderate | Lam Facetc Frmt Arthrd Lum 1, Laminectomy Facetectomy Or Foraminotomy Unilateral Or Bilateral With Decompression Of Spinal Cord Cauda Equina And Or Nerve Root S Eg Spinal Or Lateral Recess Stenosis During Posterior Interbody Arthrodesis Lumbar Single Vertebral Segment List Separately In Addition To Code For Primary Procedure |
| 63053-CPT | Moderate | Lam Factc Frmt Arthrd Lum Ea, Laminectomy Facetectomy Or Foraminotomy Unilateral Or Bilateral With Decompression Of Spinal Cord Cauda Equina And Or Nerve Root S Eg Spinal Or Lateral Recess Stenosis During Posterior Interbody Arthrodesis Lumbar Each Additional Vertebral Segment 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 63052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63052 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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