63621 Srs spinal lesion addl
What 63621 is
CMS fee schedule short descriptor: Srs spinal lesion addl.
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 63621 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 3.90 | 1.37 | 1.64 | 6.91 | $230.80 |
| Facility (hospital, ASC) | 3.90 | 1.37 | 1.64 | 6.91 | $230.80 |
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 63621 at 2 units per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 63621? These codes are bundled into it
63621 is a Column 1 code in 9 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 |
61783 | Scan proc spinal | 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 |
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.