Rate Benchmarking
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See a sample rate comparisonCPT 63053 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
| 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 | $204.75 national non-facility rate (2026) · View Medicare rates for 63053 |
| Medicaid Fee Schedule | $156.32 median of the 8 states in the free preview · View Medicaid rates for 63053 |
National average reimbursement for CPT 63053 by major payers:

$263.34
BCBS / Anthem

$281.19
UnitedHealthcare

$287.02
Aetna

$360.49
Cigna
Choose a payer to see a sample of rates for CPT 63053.
Northfield Surgical Center LLC, Northfield Surgical Center
Northfield Surgical Center LLC
Riva Road Surgical Center, LLC
Riva Road Surgical Center LLC
North Fork Surgery Center LLC
Smart Pain Surgery Center At Germantown, LLC, Clearway Surgery Center Of Germantown
Smart Pain Surgery Center At Germantown LLC
John P Lydon Dpm, Bethesda Ambulatory Surgical Center
John P Lydon, Dpm
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 63053 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 63053. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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 |
| 63055-CPT | High | Decompress Spinal Cord Thrc, Transpedicular Approach With Decompression Of Spinal Cord Equina And Or Nerve Root S Eg Herniated Intervertebral Disc Single Segment Thoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63053. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63053 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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