How much does Medicare pay for CPT 63053?

Medicare allowed an average of $156.39 per service and paid $124.78 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $764.06, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Which specialty bills 63053 most?

Neurosurgery, with 3,090 services from 119 clinicians. Next are Orthopedic Surgery, Physician Assistant, Nurse Practitioner.

CPT 63053

Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back

$156.39Medicare-allowed amount per service, averaged across 8,929 services

Providers submitted

$764.06

Asking price, not received

Medicare allowed

$156.39

The fee schedule figure

Medicare paid

$124.78

Balance is patient coinsurance

Providers submitted an average of $764.06 for this code and Medicare allowed $156.39 — 4.9× 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 $124.78 (80%); the rest is the patient’s coinsurance and deductible.

Services: 8,929
Beneficiaries: 6,458
Providers billing it: 353
Total allowed: $1,396,406

What Medicare pays for CPT 63053

Across 8,929 services billed by 353 providers to 6,458 beneficiaries, Medicare allowed an average of $156.39 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. 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 63053

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	3,090	2,211	$216.97	119
Orthopedic Surgery	2,910	2,130	$216.32	115
Physician Assistant	2,406	1,724	$30.01	98
Nurse Practitioner	475	362	$30.16	20
Osteopathic Manipulative Medicine	48	31	$207.04	1

63053 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
Texas	1,036	$152.29	$123.60	39
Arizona	895	$139.51	$114.91	23
Florida	885	$170.06	$125.51	32
Virginia	507	$162.91	$136.90	16
Pennsylvania	419	$171.80	$139.22	14
Ohio	411	$152.01	$126.35	15
Colorado	367	$153.29	$123.52	15
Maryland	329	$173.02	$131.19	10
Indiana	297	$120.16	$114.30	14
Georgia	271	$153.37	$125.06	13
Massachusetts	250	$164.56	$135.11	12
California	248	$165.58	$133.33	11
Louisiana	230	$134.36	$112.85	9
Illinois	227	$193.42	$135.59	11
North Dakota	204	$117.87	$104.01	4
Washington	178	$178.08	$143.21	8
Montana	156	$161.13	$129.11	5
North Carolina	155	$162.71	$141.90	8
New York	139	$200.31	$133.37	10
Nevada	138	$141.97	$115.34	6
Michigan	132	$170.76	$129.71	8
Tennessee	126	$167.18	$151.61	6
Oklahoma	118	$135.30	$114.39	5
Nebraska	117	$156.22	$145.76	5
New Jersey	107	$152.07	$114.71	3
Missouri	103	$159.02	$134.60	5
South Carolina	101	$143.62	$121.83	7
Alabama	87	$114.05	$102.24	4
Minnesota	79	$158.79	$143.23	4
Idaho	71	$118.68	$115.58	3
Kansas	68	$119.38	$103.62	4
Mississippi	66	$150.67	$141.48	4
Kentucky	63	$151.00	$124.85	3
Iowa	55	$186.23	$167.72	3
District of Columbia	54	$249.11	$178.27	1
Utah	52	$176.80	$145.79	3
Oregon	36	$107.31	$102.80	2
Rhode Island	27	$215.48	$173.40	1
Wisconsin	27	$195.49	$178.49	1
Wyoming	23	$224.73	$178.52	1
West Virginia	19	$32.83	$24.35	1
Arkansas	16	$192.13	$181.65	1
Delaware	15	$29.39	$24.27	1
South Dakota	14	$160.96	$146.56	1
Maine	11	$210.54	$177.96	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
63030Partial removal of spine bone$1056.97
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.