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CPT®
63198

CPT® Code 63198
Deleted

Official Description

Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; cervical

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 63198 involves a laminectomy combined with a cordotomy, specifically targeting the anterior spinothalamic tracts in the cervical region. A laminectomy is a surgical procedure that entails the removal of a portion of the vertebral bone called the lamina, which allows access to the spinal cord. The primary goal of this procedure is to selectively destroy the spinothalamic tracts, which are critical pathways for transmitting pain sensations from the body to the brain. This procedure can be performed in two stages within a 14-day period, allowing for a more controlled approach to managing severe pain, particularly in terminally ill patients suffering from malignancies. The spinothalamic tracts are located bilaterally in the anterolateral aspect of the spinal cord, and their destruction can significantly alleviate unilateral pain. Although the use of cordotomy has diminished with the introduction of newer pain management techniques, it remains a viable option for patients experiencing intractable pain that is not responsive to other treatments. The surgical approach involves making an incision over the cervical or thoracic spine, retracting the muscles, and utilizing a bone drill to expose the spinal cord for the precise identification and sectioning of the spinothalamic tracts.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for patients experiencing severe unilateral pain, particularly due to malignancy in terminally ill individuals. It is specifically utilized when other pain management modalities have failed to provide adequate relief. The primary goal is to alleviate intractable pain by targeting the pain-transmitting pathways within the spinal cord.

  • Severe Unilateral Pain This procedure is primarily indicated for patients suffering from severe unilateral pain, often associated with malignancies.
  • Terminal Illness It is particularly relevant for terminally ill patients who may benefit from pain relief as part of palliative care.
  • Failure of Other Pain Management Techniques The procedure is considered when other pain management strategies have proven ineffective.

2. Procedure

The procedure consists of several critical steps that ensure the effective execution of the laminectomy and cordotomy.

  • Step 1: Incision The surgical process begins with an incision made over the vertebrae in the cervical or thoracic spine, depending on the specific location of the spinothalamic tract to be targeted. This incision is carefully extended down to the spinous processes to provide adequate access to the underlying structures.
  • Step 2: Muscle Retraction Once the incision is made, the surrounding muscles are retracted away from the lamina and facet joint. This retraction is crucial for exposing the bony structures and the spinal cord without causing unnecessary damage to the surrounding tissues.
  • Step 3: Laminectomy A bone drill is then employed to remove part or all of the lamina, which is the bony arch of the vertebra. This step is essential for exposing the spinal cord and the targeted spinothalamic tracts.
  • Step 4: Identification and Sectioning of the Spinothalamic Tract With the spinal cord now exposed, the surgeon identifies the spinothalamic tract. This tract is carefully cut to achieve the desired effect of pain relief. The precision in this step is vital to ensure that only the intended pathways are affected.

3. Post-Procedure

After the completion of the procedure, patients are typically monitored for any immediate complications related to the surgery. Post-operative care may include pain management strategies, as well as monitoring for neurological function to ensure that there are no adverse effects from the procedure. Recovery may vary depending on the individual patient's condition and the extent of the surgery performed. Follow-up appointments are essential to assess the effectiveness of the pain relief achieved and to manage any ongoing care needs.
Short Descr INCISE SPIN&CORD 2 STGS CRVL
Medium Descr LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES CERVICAL
Long Descr Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; 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) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 3 - Laminectomy, excision intervertebral disc
Date
Action
Notes
2021-12-31 Deleted Code deleted
2013-01-01 Changed Short Descriptor changed.
2009-01-01 Changed Code description changed
Pre-1990 Added Code added.
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