63295 Repair laminectomy defect
What 63295 is
CMS fee schedule short descriptor: Repair laminectomy defect.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 63295 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 5.12 | 1.79 | 2.15 | 9.06 | $302.61 |
| Facility (hospital, ASC) | 5.12 | 1.79 | 2.15 | 9.06 | $302.61 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.
Medically Unlikely Edit (MUE)
Medicare caps 63295 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 63295? These codes are bundled into it
63295 is a Column 1 code in 14 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
38220 | Dx bone marrow aspirations | 0 - no modifier bypass | Check pair |
38222 | Dx bone marrow bx & aspir | 0 - no modifier bypass | Check pair |
38230 | Bone marrow harvest allogen | 0 - no modifier bypass | Check pair |
38232 | Bone marrow harvest autolog | 0 - no modifier bypass | Check pair |
63707 | Repair spinal fluid leakage | 1 - modifier may bypass | Check pair |
63709 | Repair spinal fluid leakage | 1 - modifier may bypass | Check pair |
95863 | Needle emg 3 extremities | 0 - no modifier bypass | Check pair |
95864 | Needle emg 4 extremities | 0 - no modifier bypass | Check pair |
95865 | Needle emg larynx | 0 - no modifier bypass | Check pair |
95866 | Needle emg hemidiaphragm | 0 - no modifier bypass | Check pair |
95869 | Ndl emg thrc paraspinal musc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
63295 is bundled into these codes
63295 appears as a Column 2 code in 18 active edits. Reported with one of these Column 1 codes on the same date of service, 63295 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0219T | Plmt post facet implt cerv | 1 | Check pair |
0220T | Plmt post facet implt thor | 1 | Check pair |
0221T | Plmt post facet implt lumb | 1 | Check pair |
22206 | Incis spine 3 column thorac | 1 | Check pair |
22207 | Incis spine 3 column lumbar | 1 | Check pair |
22590 | Arthrd pst tq craniocervical | 1 | Check pair |
22595 | Arthrd pst tq atlas-axis | 1 | Check pair |
22600 | Arthrd pst tq 1ntrspc crv | 1 | Check pair |
22610 | Arthrd pst tq 1ntrspc thrc | 1 | Check pair |
22612 | Arthrd pst tq 1ntrspc lumbar | 1 | Check pair |
22633 | Arthrd cmbn 1ntrspc lumbar | 1 | Check pair |
22634 | Arthrd cmbn 1ntrspc ea addl | 1 | Check pair |
22840 | Insert spine fixation device | 1 | Check pair |
22842 | Insert spine fixation device | 1 | Check pair |
22843 | Insert spine fixation device | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.