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See a sample rate comparisonCPT 63052 Fee Schedule
Medicare rates as of October 2026
CPT 63052 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
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 | AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $229.80 national non-facility rate (2026) · View Medicare rates for 63052 |
| Medicaid Fee Schedule | $175.54 median of the 8 states in the free preview · View Medicaid rates for 63052 |
National average reimbursement for CPT 63052 by major payers:
$326.34
BCBS / Anthem
$371.49
UnitedHealthcare
$364.77
Aetna
$439.79
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 63052.
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 table lists codes related to 63052. Select one to see its fee schedule.
| 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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Frequently Asked Questions
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to describe medical, surgical, and diagnostic services. These codes are crucial for standardized communication between providers, payers (insurance companies), and patients, ensuring accurate billing and reimbursement for services rendered.
To find the specific cost of a medical procedure or service, especially considering your particular location and the specific CPT code, you can utilize a specialized lookup tool. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and specific location to get relevant pricing information, helping you understand potential costs based on your individual situation.
You can look up fee schedules for healthcare services using tools designed for price transparency. Payerprice provides a fee schedule lookup tool that allows users to search for prices based on CPT codes and specific geographical locations, offering insights into what different payers might reimburse or what providers might charge in your area.
Several factors can influence the final cost of a medical bill, including the type and complexity of the service, the healthcare provider's fees, geographic location, whether the provider is in-network or out-of-network for your insurance plan, your insurance deductible and co-pays, and any additional services or supplies used during your care.
Yes, comparing prices for medical procedures beforehand is increasingly possible with price transparency tools. For specific pricing relevant to your situation, including CPT codes and location, you can use Payerprice's fee schedule lookup tool. This allows you to research potential costs and make more informed healthcare decisions.