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CPT 63047: Lumbar Laminectomy, Facetectomy, and Foraminotomy (Single Level)
CPT code 63047 represents a single-level lumbar decompression procedure — a combined laminectomy, facetectomy, and foraminotomy — performed to treat spinal stenosis and nerve-root compression. The code is widely used in spine surgery billing and is clinically significant because it captures a common operative approach to relieving radiculopathy and neurogenic claudication at one lumbar segment.
Key national payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical context for the service, typical sites of service, and how this code relates to adjacent procedure coding (for example, codes used when multiple segments are treated). The publication outlines common billing considerations and common modifiers used with operative spine codes, alongside relevant diagnosis links such as lumbar spinal stenosis and radiculopathy.
The content provides benchmarks and policy context relevant to institutional and surgeon billing practices, reimbursement coding relationships to multi-level procedures, and clinical indications commonly reported with this service. Data not available in the input is noted where necessary.
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Billing Code Overview
CPT code 63047 describes a surgical decompression of a single lumbar vertebral segment combining laminectomy, facetectomy, and foraminotomy to relieve spinal stenosis and decompress the spinal cord or nerve roots. This procedure removes portions of the posterior vertebral elements and enlarges the neural foramen at one lumbar level.
Service type: Surgical spine decompression (single lumbar level)
Typical site of service: Inpatient hospital or ambulatory surgical center (operating room)
National Reimbursement Benchmarks
Across national payers, Medicare's mean allowed amount of $1,075.10 sits below the BUCA commercial average of $3,521.50, creating a substantial commercial-to-Medicare gap of $2,446.40 in mean rates for CPT 63047. This gap highlights that BUCA reimbursements are roughly 3.3 times Medicare on average, reflecting a material divergence between federal program pricing and that segment of commercial contracts.
Dispersion (P75 minus P25) varies meaningfully: Blue Cross Blue Shield exhibits the widest interquartile spread of $5,570.00 (P75 $7,586.30 minus P25 $2,016.10), followed by BUCA at $3,686.40, and UnitedHealth Group at $1,221.80. Aetna and Cigna display tighter spreads of $1,074.00 and $1,228.90 respectively, indicating more compressed commercial variation for those carriers compared with BCBS and BUCA.