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See a sample rate comparisonCPT 63055 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Decompress Spinal Cord Thrc, Transpedicular Approach With Decompression Of Spinal Cord Equina And Or Nerve Root S Eg Herniated Intervertebral Disc Single Segment Thoracic
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 63055 |
| Medicaid Fee Schedule | View Medicaid rates for 63055 |
National average reimbursement for CPT 63055 by major payers:
$1,958.12
$2,228.24
$2,390.02
$2,629.49
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CPT 63055
5 of 25 sample ratesHigher to lower in this preview
Waverley Surgery Center LLC, Waverley Surgery Center
Waverley Surgery Center, L.P.
$9,476.00Published rateAdvanced Surgery Center Of Tampa, LLC
$6,365.00Published rateEye Md Of Niceville Surgery LLC
$4,268.00Published rateHighline South Ambulatory Surgery Center, LLC, Highline South Ambulatory Surgery Center
Highline South Ambulatory Surgery Center LLC
$3,045.00Published rateYuma Endoscopy Center
Yuma Endoscopy Center, LLC
$550.00Published rate
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See a sample payer proposalCPT 63055 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63055 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 63055 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 |
|---|---|---|
| 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 |
| 63056-CPT | High | Decompress Spinal Cord Lmbr, Transpedicular Approach With Decompression Of Spinal Cord Equina And Or Nerve Root S Eg Herniated Intervertebral Disc Single Segment Lumbar Including Transfacet Or Lateral Extraforaminal Approach Eg Far Lateral Herniated Intervertebral Disc |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63055. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63055 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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