How much does Medicare pay for CPT 63056?

Medicare allowed an average of $948.73 per service and paid $757.08 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5789.07, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 63056?

Release of lower spinal cord and/or nerves, single segment. It was billed 2,037 times to 1,991 Medicare beneficiaries by 82 providers in 2024.

Which specialty bills 63056 most?

Neurosurgery, with 733 services from 29 clinicians. Next are Orthopedic Surgery, Physician Assistant, Ambulatory Surgical Center.

CPT 63056

Release of lower spinal cord and/or nerves, single segment

$948.73Medicare-allowed amount per service, averaged across 2,037 services

Providers submitted

$5789.07

Asking price, not received

Medicare allowed

$948.73

The fee schedule figure

Medicare paid

$757.08

Balance is patient coinsurance

Providers submitted an average of $5789.07 for this code and Medicare allowed $948.73 — 6.1× 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 $757.08 (80%); the rest is the patient’s coinsurance and deductible.

Services: 2,037
Beneficiaries: 1,991
Providers billing it: 82
Total allowed: $1,932,563

What Medicare pays for CPT 63056

Across 2,037 services billed by 82 providers to 1,991 beneficiaries, Medicare allowed an average of $948.73 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 63056

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	733	713	$1044.90	29
Orthopedic Surgery	497	490	$863.27	23
Physician Assistant	445	432	$118.46	14
Ambulatory Surgical Center	167	163	$3369.75	7
Nurse Practitioner	104	103	$104.75	4
Cardiology	37	37	$695.55	1
Pain Management	24	23	$1658.50	2
Anesthesiology	15	15	$1654.64	1
Physical Medicine and Rehabilitation	15	15	$1392.97	1

63056 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	783	$655.46	$495.76	24
Maryland	214	$1279.55	$963.51	8
Florida	200	$645.44	$455.70	7
Nevada	148	$712.75	$559.18	8
Minnesota	113	$522.30	$455.27	4
Texas	66	$1258.06	$976.49	4
North Carolina	66	$2353.51	$1925.71	3
Illinois	59	$3025.47	$2355.26	2
District of Columbia	57	$1307.62	$940.30	2
South Carolina	49	$852.56	$709.22	2
Kansas	36	$89.58	$79.95	1
Arizona	36	$1764.27	$1446.15	3
Utah	28	$2166.29	$1897.78	2
Connecticut	25	$1089.48	$740.39	1
Ohio	24	$487.82	$414.22	2
Washington	23	$1263.02	$1024.45	1
Pennsylvania	19	$1558.99	$1173.00	1
Missouri	16	$1168.61	$944.19	1
Colorado	15	$901.35	$705.52	1
New York	13	$1264.69	$834.20	1
Idaho	13	$710.28	$640.67	1
Virginia	12	$1123.65	$930.23	1
Arkansas	11	$1230.60	$1177.33	1
Massachusetts	11	$802.64	$641.39	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
63030Partial removal of spine bone$1056.97
63045Partial removal of spine bone$692.40
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.