CPT 63048
Global ZZZ ActiveLam facetec &foramot ea addl
CPT 63048 Billing & Documentation Guide
CPT code 63048 (Lam facetec &foramot ea addl) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.38, a non-facility practice expense RVU of 1.13, and a malpractice RVU of 1.1, a total non-facility RVU of 5.61 and facility RVU of 5.61. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $186.04, though rates vary from $160.37 to $245.1 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 63048, 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 63048 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 5 units of 63048 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 63048
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.38 | 3.38 |
| Practice Expense RVU | 1.13 | 1.13 |
| Malpractice RVU | 1.1 | 1.1 |
| Total RVU | 5.61 | 5.61 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 63048
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 | $181.53 | $181.53 | $175.87 - $199.43 | 29 |
| Florida | $222.29 | $222.29 | $204.2 - $245.1 | 3 |
| Georgia | $193.04 | $193.04 | $190.36 - $195.71 | 2 |
| Illinois | $219.97 | $219.97 | $204.78 - $235.94 | 4 |
| Michigan | $200.05 | $200.05 | $188.83 - $211.26 | 2 |
| North Carolina | $171.59 | $171.59 | $171.59 - $171.59 | 1 |
| New York | $210.3 | $210.3 | $174.58 - $233.22 | 5 |
| Ohio | $184.39 | $184.39 | $184.39 - $184.39 | 1 |
| Pennsylvania | $190.16 | $190.16 | $182.26 - $198.05 | 2 |
| Texas | $184.8 | $184.8 | $179.86 - $201.83 | 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 63048
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 63048 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11006 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11042 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11043 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11044 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 63048
What does CPT code 63048 mean? +
CPT code 63048 represents: Lam facetec &foramot ea addl. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 63048? +
The 2026 Medicare national average non-facility payment for CPT 63048 is $186.04. Rates range from $160.37 to $245.1 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 63048? +
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 63048? +
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 May 31, 2026.
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