CPT 63042

Lamot Prtl Ffd Exc Disc Reexpl 1 Ntrspc Lumbar

CPT 63042 pays $1,219.80 in a non-facility setting and $1,219.80 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $1,070.75 in Arkansas to $1,470.41 in Alaska, a 37% spread.

National non-facility rate

$1,219.80

Office and other outpatient settings

Facility rate
$1,219.80

Hospital and ASC settings

Highest state
$1,470.41

Alaska

Lowest state
$1,070.75

Arkansas · 37% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $1,219.80
CPT 63042 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $1,219.80, national facility $1,219.80.
StateRate compared visuallyNon-facilityFacility
Alaska
$1,470.41$1,470.41
Florida
$1,395.13$1,395.13
Illinois
$1,374.94$1,374.94
New York
$1,363.97$1,363.97
District of Columbia
$1,349.23$1,349.23
New Jersey
$1,319.99$1,319.99
Connecticut
$1,303.34$1,303.34
Michigan
$1,268.72$1,268.72
Massachusetts
$1,260.97$1,260.97
Maryland
$1,260.05$1,260.05
Washington
$1,259.81$1,259.81
West Virginia
$1,243.28$1,243.28
Georgia
$1,237.26$1,237.26
California
$1,235.54$1,235.54
Pennsylvania
$1,229.26$1,229.26
Rhode Island
$1,225.60$1,225.60
Puerto Rico
$1,221.72$1,221.72
Virgin Islands
$1,221.72$1,221.72
New Mexico
$1,221.43$1,221.43
Montana
$1,219.43$1,219.43
New Hampshire
$1,214.27$1,214.27
Colorado
$1,214.11$1,214.11
Texas
$1,203.50$1,203.50
Hawaii
$1,200.71$1,200.71
Delaware
$1,199.20$1,199.20
Oregon
$1,196.64$1,196.64
Louisiana
$1,191.44$1,191.44
Nevada
$1,189.55$1,189.55
Ohio
$1,184.28$1,184.28
Missouri
$1,181.92$1,181.92
Arizona
$1,180.17$1,180.17
Utah
$1,175.55$1,175.55
Wyoming
$1,172.04$1,172.04
South Carolina
$1,159.93$1,159.93
Virginia
$1,158.56$1,158.56
Kentucky
$1,156.99$1,156.99
Oklahoma
$1,133.34$1,133.34
Maine
$1,132.27$1,132.27
North Carolina
$1,125.00$1,125.00
Vermont
$1,124.80$1,124.80
Mississippi
$1,112.75$1,112.75
North Dakota
$1,110.68$1,110.68
Minnesota
$1,102.80$1,102.80
South Dakota
$1,097.82$1,097.82
Tennessee
$1,096.05$1,096.05
Indiana
$1,094.34$1,094.34
Idaho
$1,088.97$1,088.97
Kansas
$1,087.86$1,087.86
Alabama
$1,086.92$1,086.92
Wisconsin
$1,074.82$1,074.82
Iowa
$1,072.89$1,072.89
Nebraska
$1,072.80$1,072.80
Arkansas
$1,070.75$1,070.75

Billed by 1 specialties

Commercial rates for 63042

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates