Rate Benchmarking
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See a sample rate comparisonCPT 63252 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | 80 - Assistant surgeon GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $2,903.87 national non-facility rate (2026) · View Medicare rates for 63252 |
| Medicaid Fee Schedule | $2,247.60 median of the 8 states in the free preview · View Medicaid rates for 63252 |
National average reimbursement for CPT 63252 by major payers:

$3,681.22
BCBS / Anthem

$4,144.26
UnitedHealthcare

$4,254.18
Aetna

$4,832.29
Cigna
Choose a payer to see a sample of rates for CPT 63252.
Mclean Ambulatory Surgery, LLC
Mclean Ambulatory Surgery LLC
Physicians Surgery Center LLC, National Spine & Ortho Surgery Center Of Ft. Myers
Physicians Surgery Center LLC
Texas Endoscopy Centers, LLC, Texas Endoscopy
Northern New Jersey Center For Advanced Endoscopy LLC
Mid-Bronx Endoscopy Center LLC
Midbronx Endoscopy Center LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 63252 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 63252. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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). |
| 63252-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). |
| 63265-CPT | High | Remove Lesion From Spine, Surgery To Remove A Portion Of Vertebra (Spine) And Abnormal Tissue (Lesion) From The Spinal Cord In The Neck. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63252. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63252 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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