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CPT®
63194

CPT® Code 63194
Deleted

Official Description

Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; cervical

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Laminectomy with cordotomy, as described by CPT® Code 63194, is a surgical procedure aimed at alleviating severe pain by selectively targeting the anterior spinothalamic tract, which is the primary pathway for pain transmission within the spinal cord. This procedure is typically indicated for patients experiencing significant unilateral pain, often due to malignancies, particularly in terminally ill individuals. The anterior spinothalamic tract is located bilaterally in the anterolateral region of the spinal cord, with each side transmitting sensory information from the opposite side of the body to the brain. The procedure can be performed in a single operation or as part of a two-stage approach, and it can be executed unilaterally or bilaterally depending on the patient's specific condition and pain distribution. The surgical approach involves making an incision over the cervical or thoracic vertebrae where the targeted spinothalamic tract is located, followed by the removal of bone to expose the spinal cord. This allows for the precise identification and sectioning of the spinothalamic tract, thereby interrupting the pain signals being transmitted to the brain.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

  • Severe Unilateral Pain The primary indication for performing a laminectomy with cordotomy is to address severe unilateral pain, particularly in patients suffering from malignancies.
  • Terminal Illness This procedure is often reserved for terminally ill patients who are experiencing significant pain that cannot be managed through other means.

2. Procedure

  • Incision The procedure begins with an incision made over the cervical or thoracic spine, specifically at the vertebra where the spinothalamic tract is to be targeted. This incision is carefully extended down to the spinous processes to provide adequate access to the underlying structures.
  • Muscle Retraction Once the incision is made, the surrounding muscle tissue is retracted away from the lamina and facet joint to expose the bony structures of the spine. This step is crucial for gaining access to the lamina that will be removed.
  • Laminectomy A bone drill is then utilized to remove part or all of the lamina, which is the bony arch of the vertebra. This removal is necessary to expose the spinal cord adequately for the subsequent steps of the procedure.
  • Exposure of the Spinal Cord After the lamina has been removed, the spinal cord is exposed, allowing the surgeon to visualize the anatomical structures and locate the spinothalamic tract.
  • Identification and Sectioning of the Spinothalamic Tract The final step involves identifying the spinothalamic tract and carefully cutting it. This action interrupts the pain transmission pathway, thereby alleviating the patient's pain.

3. Post-Procedure

Post-procedure care for patients undergoing a laminectomy with cordotomy typically involves monitoring for any complications related to the surgery, such as infection or neurological deficits. Patients may experience immediate relief from pain, but recovery can vary based on individual circumstances. Follow-up appointments are essential to assess the effectiveness of the procedure and to manage any ongoing pain or complications. Rehabilitation may also be recommended to aid in recovery and to help the patient adjust to any changes in sensory perception resulting from the interruption of the spinothalamic tract.
Short Descr INCISE SPINE & CORD CERVICAL
Medium Descr LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT CERVICAL
Long Descr Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; cervical
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1F - Major procedure - explor/decompr/excis disc
MUE Not applicable/unspecified.
CCS Clinical Classification 3 - Laminectomy, excision intervertebral disc
Date
Action
Notes
2021-12-31 Deleted Code deleted
2013-01-01 Note Short Descriptor changed.
2009-01-01 Changed Code description changed
Pre-1990 Added Code added.
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