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See a sample rate comparisonCPT 63281 Fee Schedule
Last Verified: October 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 Middle 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 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63281 |
| Medicaid Fee Schedule | View Medicaid rates for 63281 |
National average reimbursement for CPT 63281 by major payers:
$2,677.67
$2,862.62
$3,004.44
$3,367.44
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CPT 63281
5 of 25 sample ratesHigher to lower in this preview
Orthopaedic Specialists Surgi-Center, LLC
Orthopaedic Specialists Surgicenter LLC
$4,300.00Published rateSouth County Outpatient Endoscopy Services, Lp, Scopes Endoscopy Center
$1,167.00Published rateWestern Washington Medical Group, Inc, Ps, Dba: Gateway Surgery Center
Western Washington Medical Group, Inc., P.S.
$885.00Published rateOphthalmology Center Of Brevard Lp, Asc Of Brevard
Ophthalmology Center Of Brevard Lp
$463.00Published rateSalvatore Dimercurio Md PA
Salvatore Dimercurio, M.D., P.A.
$100.00Published rate
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See a sample payer proposalCPT 63281 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63281 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 63281 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 |
|---|---|---|
| 63271-CPT | High | Remove Lesion From Spine, Surgery To Remove A Portion Of Vertebra (Spine) And Abnormal Tissue (Lesion) From The Spinal Cord In The Upper Back. |
| 63276-CPT | High | Spine Surgery For Tumor, Surgery To Remove A Tumor Located Inside The Spine In The Middle Back. The Procedure Requires Removing A Spine Bone (Vertebra) And May Include Removing A Sample Of Tissue For Testing (Biopsy). |
| 63281-CPT | High | Spine Surgery For Tumor, Surgery To Remove A Tumor Located Inside The Spine In The Middle Back. The Procedure Requires Removing A Spine Bone (Vertebra) And May Include Removing A Sample Of Tissue For Testing (Biopsy). |
| 63286-CPT | High | Spine Surgery For Tumor, Surgery To Remove A Tumor Located Inside The Spine In The Middle Back. The Procedure Requires Removing A Spine Bone (Vertebra) And May Include Removing A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63281. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63281 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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