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See a sample rate comparisonCPT 63268 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.
Remove Lesion From Spine, Surgery To Remove A Portion Of Vertebra (Spine) And Abnormal Tissue (Lesion) From The Spinal Cord In The Lower Back.
| 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 58 - Staged or related procedure during postoperative period AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63268 |
| Medicaid Fee Schedule | View Medicaid rates for 63268 |
National average reimbursement for CPT 63268 by major payers:
$1,679.37
$1,925.30
$1,998.46
$2,296.54
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CPT 63268
5 of 25 sample ratesHigher to lower in this preview
Front Range Orthopedic Surgery Center LLC
$28,000.00Published rateAdvanced Surgery Center Of Northern Louisiana LLC
Advanced Surgery Center Of Northern Louisiana, LLC
$6,492.00Published rateNura Surgical Center LLC, Minneapolis Pain Centers LLC
$3,671.00Published rateThe Center For Specialized Surgery, Lp
$3,000.00Published rateMei Surgery Center LLC, Michigan Eye Surgery Center
Mei Surgery Center LLC
$900.00Published rate
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See a sample payer proposalCPT 63268 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63268 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 63268 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 |
|---|---|---|
| 63268-CPT | High | Remove Lesion From Spine, Surgery To Remove A Portion Of Vertebra (Spine) And Abnormal Tissue (Lesion) From The Spinal Cord In The Lower Back. |
| 63273-CPT | High | Remove Lesion From Spine, Surgery To Remove A Portion Of Vertebra (Spine) And Abnormal Tissue (Lesion) From The Spinal Cord In The Lower Back. |
| 63278-CPT | High | Spine Surgery For Tumor, Surgery To Remove A Tumor Located Inside The Spine In The Lower Back. The Procedure Requires Removing A Spine Bone (Vertebra) And May Include Removing A Sample Of Tissue For Testing (Biopsy). |
| 63295-CPT | Moderate | Repair Laminectomy Defect, Osteoplastic Reconstruction Of Dorsal Spinal Elements Following Primary Intraspinal Procedure (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 63268. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63268 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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