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See a sample rate comparisonCPT 63278 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.
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).
| 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 AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63278 |
| Medicaid Fee Schedule | View Medicaid rates for 63278 |
National average reimbursement for CPT 63278 by major payers:
$1,977.15
$2,156.97
$2,215.38
$2,553.39
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CPT 63278
5 of 25 sample ratesHigher to lower in this preview
Port St Lucie Surgery Center Ltd
$2,732.00Published rateFullerton Surgical Center, Lp, Fullerton Surgical Center
Fullerton Surgical Center Lp
$1,270.00Published rateGreat Lakes Surgical Center LLC
Great Lakes Surgical Center Ll
$782.00Published rateNorth Crescent Surgery Center, L.L.C.
North Crescent Surgery Center LLC
$520.00Published rateApollo Surgery Center LLC
$104.00Published rate
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See a sample payer proposalCPT 63278 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63278 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 63278 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 63278. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63278 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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