63251
Active90-day globalRevise spinal cord vsls thrc
2026 Medicare payment
Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 63251 | 1 | $2,904.54 | $2,904.54 |
| add-on22840 | 0 | $668.35/ unit | $668.35/ unit |
| add-on22841 | 0 | $0.00/ unit | $0.00/ unit |
| add-on22842 | 0 | $680.04/ unit | $680.04/ unit |
| add-on22843 | 0 | $728.47/ unit | $728.47/ unit |
| add-on22844 | 0 | $875.10/ unit | $875.10/ unit |
| add-on22845 | 0 | $647.64/ unit | $647.64/ unit |
| add-on22846 | 0 | $673.36/ unit | $673.36/ unit |
| add-on22847 | 0 | $687.39/ unit | $687.39/ unit |
| add-on22848 | 0 | $317.64/ unit | $317.64/ unit |
| add-on22853 | 0 | $228.80/ unit | $228.80/ unit |
| add-on22854 | 0 | $300.61/ unit | $300.61/ unit |
| add-on22859 | 0 | $300.27/ unit | $300.27/ unit |
| add-on63295 | 0 | $302.61/ unit | $302.61/ unit |
| add-on69990 | 0 | $198.07/ unit | $198.07/ unit |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 63251 | 43.52 | 25.07 | 25.07 | 18.37 | 86.96 |
Payment policy for 63251
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=0Physician service
Cannot be split into professional/technical components — modifiers 26 and TC don't apply.
Multiple procedures
mult_surg=2Standard MPPR
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Bilateral (modifier 50)
bilt_surg=0150% rule doesn't apply
Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).
Assistant surgeon (80/81/82)
asst_surg=2Payable
Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.
Co-surgeons (modifier 62)
co_surg=1Payable with documentation
Co-surgeons paid (62.5% each) if medical necessity is documented.
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
Global surgery package
Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 11% is attributed to pre-operative care, 76% to the procedure itself, and 13% to post-operative visits.
Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.