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See a sample rate comparisonCPT 63053 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 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
| 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 63053 |
| Medicaid Fee Schedule | View Medicaid rates for 63053 |
National average reimbursement for CPT 63053 by major payers:
$263.34
$281.19
$287.02
$360.49
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CPT 63053
5 of 25 sample ratesHigher to lower in this preview
Northfield Surgical Center LLC, Northfield Surgical Center
Northfield Surgical Center LLC
$1,306.00Published rateRiva Road Surgical Center, LLC
Riva Road Surgical Center LLC
$555.00Published rateNorth Fork Surgery Center LLC
$250.00Published rateSmart Pain Surgery Center At Germantown, LLC, Clearway Surgery Center Of Germantown
Smart Pain Surgery Center At Germantown LLC
$120.00Published rateJohn P Lydon Dpm, Bethesda Ambulatory Surgical Center
John P Lydon, Dpm
$37.00Published rate
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See a sample payer proposalCPT 63053 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63053 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 63053 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 |
|---|---|---|
| 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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