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See a sample rate comparisonCPT 63056 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 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 | None 59 - Distinct Procedural Service AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63056 |
| Medicaid Fee Schedule | View Medicaid rates for 63056 |
National average reimbursement for CPT 63056 by major payers:
$1,815.69
$2,043.91
$2,153.49
$2,419.05
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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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See a sample payer proposalCPT 63056 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63056 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 63056 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 |
|---|---|---|
| 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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