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See a sample rate comparisonCPT 63252 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 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 80 - Assistant surgeon GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63252 |
| Medicaid Fee Schedule | View Medicaid rates for 63252 |
National average reimbursement for CPT 63252 by major payers:
$3,681.22
$4,144.26
$4,254.18
$4,832.29
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CPT 63252
5 of 25 sample ratesHigher to lower in this preview
Mclean Ambulatory Surgery, LLC
Mclean Ambulatory Surgery LLC
$20,842.00Published ratePhysicians Surgery Center LLC, National Spine & Ortho Surgery Center Of Ft. Myers
Physicians Surgery Center LLC
$10,701.00Published rateTexas Endoscopy Centers, LLC, Texas Endoscopy
$5,495.00Published rateNorthern New Jersey Center For Advanced Endoscopy LLC
$3,645.00Published rateMid-Bronx Endoscopy Center LLC
Midbronx Endoscopy Center LLC
$400.00Published rate
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See a sample payer proposalCPT 63252 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63252 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 63252 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 |
|---|---|---|
| 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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