63295
ActiveAdd-on codeRepair laminectomy defect
63295 is an add-on code — it is only payable alongside a primary procedure: 63172, 63173, 63185, 63190, 63200, 63250, 63251, 63252, 63265, 63266, 63267, 63268, 63270, 63271, 63272, 63273, 63275, 63276, 63277, 63278, 63280, 63281, 63282, 63283, 63285, 63286, 63287, 63290.
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) |
|---|---|---|---|
| 63295 | 1 | $302.61 | $302.61 |
| 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) |
|---|---|---|---|---|---|
| 63295 | 5.12 | 1.79 | 1.79 | 2.15 | 9.06 |
Payment policy for 63295
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=0No reduction
No multiple-procedure payment adjustment applies (typical for add-on codes).
Bilateral (modifier 50)
bilt_surg=2Already bilateral
The fee already assumes a bilateral service — modifier 50 doesn't change payment.
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=2Payable
Co-surgeons (mod 62) are paid 62.5% of the fee each (125% total, split).
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
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.