CPT 63011
Global 090 ActiveRemove spine lamina 1/2 scrl
CPT 63011 Billing & Documentation Guide
CPT code 63011 (Remove spine lamina 1/2 scrl) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 15.51, a non-facility practice expense RVU of 10.72, and a malpractice RVU of 4.03, a total non-facility RVU of 30.26 and facility RVU of 30.26. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1017.53, though rates vary from $894.94 to $1232.57 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 63011, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 63011 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 63011 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 63011
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 15.51 | 15.51 |
| Practice Expense RVU | 10.72 | 10.72 |
| Malpractice RVU | 4.03 | 4.03 |
| Total RVU | 30.26 | 30.26 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 63011
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1033.29 | $1033.29 | $991.43 - $1163.5 | 29 |
| Florida | $1139.33 | $1139.33 | $1062.66 - $1231.2 | 3 |
| Georgia | $1021.47 | $1021.47 | $997.89 - $1045.05 | 2 |
| Illinois | $1123.07 | $1123.07 | $1055.34 - $1190.44 | 4 |
| Michigan | $1043.72 | $1043.72 | $996.92 - $1090.52 | 2 |
| North Carolina | $938.13 | $938.13 | $938.13 - $938.13 | 1 |
| New York | $1125.06 | $1125.06 | $952.83 - $1226.9 | 5 |
| Ohio | $980.64 | $980.64 | $980.64 - $980.64 | 1 |
| Pennsylvania | $1017.33 | $1017.33 | $973.95 - $1060.7 | 2 |
| Texas | $998.44 | $998.44 | $968.93 - $1062.96 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 63011
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 63011 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0333T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0464T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0565T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 63011
What does CPT code 63011 mean? +
CPT code 63011 represents: Remove spine lamina 1/2 scrl. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 63011? +
The 2026 Medicare national average non-facility payment for CPT 63011 is $1017.53. Rates range from $894.94 to $1232.57 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 63011? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 63011? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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