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See a sample rate comparisonCPT 63285 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 Neck. 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 19 - Off Campus Outpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63285 |
| Medicaid Fee Schedule | View Medicaid rates for 63285 |
National average reimbursement for CPT 63285 by major payers:
$3,320.90
$3,577.09
$3,711.79
$4,184.46
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CPT 63285
5 of 25 sample ratesHigher to lower in this preview
Pinnacle Surgery Center, Inc
Pinnacle Surgery Center Inc
$40,000.00Published rateMain Street Specialty Surgery Center, LLC
Main Street Specialty Surgery Center
$1,607.00Published rateJoliet Surgery Center Limited Partnership, Amsurg Surgery Center
Joliet Surgery Center Limited Partnership
$850.00Published rateRoanoke Valley Center For Sight LLC
$477.00Published rateNorth Fullerton Surgery Center, LLC
$270.00Published rate
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See a sample payer proposalCPT 63285 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63285 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 63285 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 |
|---|---|---|
| 63270-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. |
| 63275-CPT | High | Spine Surgery For Tumor, Surgery To Remove A Tumor Located Inside The Spine In The Neck. The Procedure Requires Removing A Spine Bone (Vertebra) And May Include Removing A Sample Of Tissue For Testing (Biopsy). |
| 63280-CPT | High | Spine Surgery For Tumor, Surgery To Remove A Tumor Located Inside The Spine In The Neck. The Procedure Requires Removing A Spine Bone (Vertebra) And May Include Removing A Sample Of Tissue For Testing (Biopsy). |
| 63285-CPT | High | Spine Surgery For Tumor, Surgery To Remove A Tumor Located Inside The Spine In The Neck. 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 63285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63285 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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