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See a sample rate comparisonCPT 63250 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.
Surgery On Spine Blood Vessels, Surgery On The Spine In Order To Repair An Artery And Vein That Have Formed Improperly. The Procedure Requires Removing A Portion Of A Spine Bone (Vertebra).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63250 |
| Medicaid Fee Schedule | View Medicaid rates for 63250 |
National average reimbursement for CPT 63250 by major payers:
$3,702.39
$4,026.31
$4,129.64
$4,701.79
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CPT 63250
5 of 25 sample ratesHigher to lower in this preview
Atlantic Gastro Surgicenter, LLC, T/A Access
Atlantic Gastroenterology Associates, P.A.
$4,300.00Published rateSouthpark Surgery Center LLC, Southpark Surgery Center
Southpark Surgery Center LLC
$1,228.00Published rateSedalia Surgery Center, LLC
Sedalia Surgery Center L L C
$1,020.00Published rateAmber Meadows Surgery Center LLC
$480.00Published rateEndoscopy Associates Of Valley Forge, LLC
Endoscopy Associates Of Valley Forge LLC
$82.00Published rate
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See a sample payer proposalCPT 63250 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63250 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 63250 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 |
|---|---|---|
| 63200-CPT | High | Remove Scar Tissue On Spine, Removal Of A Portion Of Vertebra (Spine) And Surgery To Remove Adhesions (Scar Tissue) On The Spinal Cord. |
| 63250-CPT | High | Surgery On Spine Blood Vessels, Surgery On The Spine In Order To Repair An Artery And Vein That Have Formed Improperly. The Procedure Requires Removing A Portion Of A Spine Bone (Vertebra). |
| 63251-CPT | High | Surgery On Spine Blood Vessels, Surgery On The Spine In Order To Repair An Artery And Vein That Have Formed Improperly. The Procedure Requires Removing A Portion Of A Spine Bone (Vertebra). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63250 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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