How much does Medicare pay for CPT 63267?

Medicare allowed an average of $814.86 per service and paid $650.52 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5798.01, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 63267?

Removal of growth of lower spine bone outside spine membrane. It was billed 1,309 times to 1,223 Medicare beneficiaries by 69 providers in 2024.

Does 63267 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1447.31 in an office setting and $809.50 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 63267 most?

Neurosurgery, with 636 services from 34 clinicians. Next are Orthopedic Surgery, Physician Assistant, Nurse Practitioner.

CPT 63267

Removal of growth of lower spine bone outside spine membrane

$814.86Medicare-allowed amount per service, averaged across 1,309 services

Providers submitted

$5798.01

Asking price, not received

Medicare allowed

$814.86

The fee schedule figure

Medicare paid

$650.52

Balance is patient coinsurance

Providers submitted an average of $5798.01 for this code and Medicare allowed $814.86 — 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 $650.52 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1447.31
Hospital / facility: $809.50

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. 11 services were billed in an office setting and 1,298 in a facility.

Services: 1,309
Beneficiaries: 1,223
Providers billing it: 69
Total allowed: $1,066,652

What Medicare pays for CPT 63267

Across 1,309 services billed by 69 providers to 1,223 beneficiaries, Medicare allowed an average of $814.86 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 63267

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	636	592	$1017.29	34
Orthopedic Surgery	392	385	$965.72	22
Physician Assistant	261	226	$143.10	12
Nurse Practitioner	20	20	$187.38	1

63267 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	200	$855.11	$642.32	11
Texas	173	$931.65	$735.93	8
Maryland	112	$637.66	$431.34	3
Florida	107	$840.57	$589.51	5
Connecticut	84	$666.02	$466.23	4
Massachusetts	78	$1124.91	$848.17	4
Alabama	75	$119.76	$78.82	1
South Carolina	67	$895.37	$736.89	5
District of Columbia	61	$791.13	$549.04	2
New York	59	$816.74	$497.52	2
Colorado	40	$1038.61	$817.62	3
Ohio	29	$725.75	$598.24	2
Idaho	26	$600.83	$516.61	2
Arizona	24	$596.63	$466.27	2
Kansas	23	$908.83	$802.82	2
Illinois	22	$862.99	$585.06	2
North Carolina	22	$1136.58	$948.49	2
New Hampshire	16	$1359.21	$1080.86	1
Pennsylvania	13	$890.58	$669.66	1
North Dakota	12	$1265.03	$992.31	1
Delaware	11	$801.18	$642.87	1
Wisconsin	11	$835.68	$593.36	1
Virginia	11	$113.97	$73.97	1
Georgia	11	$1328.62	$1038.18	1
Missouri	11	$960.66	$689.96	1
South Dakota	11	$1237.89	$1089.31	1

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.