CPT 63621
Global ZZZ ActiveSrs spinal lesion addl
CPT 63621 Billing & Documentation Guide
CPT code 63621 (Srs spinal lesion 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 3.9, a non-facility practice expense RVU of 1.37, and a malpractice RVU of 1.64, a total non-facility RVU of 6.91 and facility RVU of 6.91. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $227.57, though rates vary from $190.97 to $316.43 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 63621, 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 63621 with related codes; this code has 9 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 2 units of 63621 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 63621
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.9 | 3.9 |
| Practice Expense RVU | 1.37 | 1.37 |
| Malpractice RVU | 1.64 | 1.64 |
| Total RVU | 6.91 | 6.91 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 63621
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 | $218.78 | $218.78 | $211.99 - $239.94 | 29 |
| Florida | $282.81 | $282.81 | $256.34 - $316.43 | 3 |
| Georgia | $239.66 | $239.66 | $236.38 - $242.93 | 2 |
| Illinois | $279.62 | $279.62 | $257.66 - $302.88 | 4 |
| Michigan | $250.33 | $250.33 | $233.89 - $266.78 | 2 |
| North Carolina | $207.96 | $207.96 | $207.96 - $207.96 | 1 |
| New York | $261.96 | $261.96 | $212.24 - $294.73 | 5 |
| Ohio | $227.26 | $227.26 | $227.26 - $227.26 | 1 |
| Pennsylvania | $234.82 | $234.82 | $224.04 - $245.59 | 2 |
| Texas | $226.91 | $226.91 | $219.38 - $252.12 | 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 63621
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 63621 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 61783 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 95863 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95864 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95865 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95866 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95869 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 63621
What does CPT code 63621 mean? +
CPT code 63621 represents: Srs spinal lesion addl. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 63621? +
The 2026 Medicare national average non-facility payment for CPT 63621 is $227.57. Rates range from $190.97 to $316.43 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 63621? +
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 63621? +
This code has 9 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 1, 2026.
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