How much does Medicare pay for CPT 63030?

Medicare allowed an average of $1056.97 per service and paid $841.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7533.26, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 63030?

Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc. It was billed 5,585 times to 5,330 Medicare beneficiaries by 294 providers in 2024.

Does 63030 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1096.91 in an office setting and $1056.69 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 63030 most?

Neurosurgery, with 1,745 services from 103 clinicians. Next are Orthopedic Surgery, Ambulatory Surgical Center, Physician Assistant.

CPT 63030

Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc

$1056.97Medicare-allowed amount per service, averaged across 5,585 services

Providers submitted

$7533.26

Asking price, not received

Medicare allowed

$1056.97

The fee schedule figure

Medicare paid

$841.23

Balance is patient coinsurance

Providers submitted an average of $7533.26 for this code and Medicare allowed $1056.97 — 7.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $841.23 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1096.91
Hospital / facility: $1056.69

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 39 services were billed in an office setting and 5,546 in a facility.

Services: 5,585
Beneficiaries: 5,330
Providers billing it: 294
Total allowed: $5,903,177

What Medicare pays for CPT 63030

Across 5,585 services billed by 294 providers to 5,330 beneficiaries, Medicare allowed an average of $1056.97 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 63030

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	1,745	1,721	$873.15	103
Orthopedic Surgery	1,596	1,583	$901.54	91
Ambulatory Surgical Center	976	778	$2767.85	36
Physician Assistant	895	885	$127.29	46
Nurse Practitioner	212	210	$137.38	12
Physical Medicine and Rehabilitation	62	56	$448.49	1
Pain Management	49	47	$815.78	2
Interventional Pain Management	36	36	$589.34	2
Anesthesiology	14	14	$514.84	1

63030 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	1,382	$999.43	$697.18	60
Florida	406	$850.26	$660.62	23
Arizona	393	$964.72	$803.06	13
Illinois	314	$890.74	$704.38	15
Texas	307	$1011.53	$820.29	17
Maryland	270	$1082.35	$834.11	15
Washington	232	$1370.80	$1025.63	13
Tennessee	177	$1699.30	$1547.11	9
Mississippi	152	$1587.64	$1429.34	8
Georgia	140	$1077.81	$881.90	9
Louisiana	137	$1431.46	$1339.07	7
Nebraska	114	$989.80	$851.61	8
New York	110	$995.38	$795.61	7
Oregon	105	$1563.56	$1236.80	6
Idaho	104	$387.91	$346.83	5
Pennsylvania	102	$855.17	$641.93	6
Massachusetts	95	$751.99	$576.29	7
North Carolina	86	$1722.31	$1483.55	6
Virginia	82	$850.35	$710.08	5
Arkansas	80	$705.28	$635.08	6
New Jersey	80	$1270.60	$946.13	5
Colorado	80	$627.19	$492.95	6
Ohio	68	$2223.65	$1889.17	3
Missouri	67	$575.14	$491.92	4
New Hampshire	65	$1100.54	$916.68	3
Kansas	51	$542.44	$464.34	4
Montana	50	$892.37	$711.50	3
Oklahoma	50	$937.70	$857.00	2
Utah	46	$1099.61	$887.84	2
Alabama	43	$340.83	$298.41	3
South Carolina	40	$964.77	$813.66	3
North Dakota	25	$1271.48	$979.66	1
Minnesota	25	$2122.81	$1678.77	2
Delaware	25	$3152.66	$2447.03	1
Iowa	15	$834.01	$749.46	1
Wyoming	12	$537.17	$452.77	1
Nevada	11	$232.06	$182.36	1
Puerto Rico	11	$113.69	$122.55	1
New Mexico	11	$1064.66	$808.33	1
Kentucky	11	$724.77	$591.97	1
Indiana	11	$548.28	$510.45	1

Related codes

63048Partial removal of spine bone$147.82
63047Partial removal of spine bone$700.79
63052Partial removal of bone of single segment of spine in lower back$172.81
63053Partial removal of bone of additional segment of spine in lower back$156.39
63045Partial removal of spine bone$692.40
63056Release of lower spinal cord and/or nerves$948.73
63042Partial removal of spine bone$1003.68
63057Release of middle or lower spinal cord and/or nerves$201.97

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.