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See a sample rate comparisonCPT 63056 Fee Schedule
Medicare rates as of October 2026
CPT 63056 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
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
| 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 | 59 - Distinct Procedural Service AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | $1,404.84 national non-facility rate (2026) · View Medicare rates for 63056 |
| Medicaid Fee Schedule | $1,085.615 median of the 8 states in the free preview · View Medicaid rates for 63056 |
National average reimbursement for CPT 63056 by major payers:
$1,815.69
BCBS / Anthem
$2,043.91
UnitedHealthcare
$2,153.49
Aetna
$2,419.05
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 63056.
CPT 63056
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$14,053.00Published rateShore Outpatient Surgicenter LLC
$6,492.00Published rateNj Vein & Cosmetic Surgery Center, PA
Nj Vein Cosmetic Surgery Center PA
$4,000.00Published rateSpecialty Surgery & Laser Center
Specialty Surgery Laser Center
$2,673.00Published rateCleveland Eye And Laser Surgery Center LLC
Cleveland Eye & Laser Surgery Center
$1,022.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 63056 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 63056. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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 |
| 63057-CPT | Moderate | Decompress Spine Cord Add On, Transpedicular Approach With Decompression Of Spinal Cord Equina And Or Nerve Root S Eg Herniated Intervertebral Disc Single Segment Each Additional Segment Thoracic Or Lumbar 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 63056. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63056 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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