CPT® Code 63650

The CPT® Code 63650 refers to the procedure of percutaneous implantation of a neurostimulator electrode array in the epidural space. This procedure is primarily performed to manage chronic back and/or leg pain through the use of spinal cord stimulation. The underlying principle of this technique involves the application of electrical stimulation to the spinal cord, which activates pain-inhibiting neurons. This activation results in a tingling sensation that effectively masks the perception of pain, providing relief to patients suffering from persistent discomfort. During the procedure, a small incision is made at the designated insertion site, and fluoroscopic guidance is utilized to ensure accurate placement of the electrode array. The procedure involves exposing the vertebra and performing a laminotomy, which entails the removal of a small portion of the lamina to access the epidural space. The electrode array, commonly referred to as leads, is then carefully advanced into this space and secured in place with sutures. Following the placement, the patient is awakened to test the electrode array, ensuring proper positioning and confirming that the implantation does not induce additional pain. The neurostimulator is calibrated at various settings to determine the most effective configuration for pain management, which will later be used to program the pulse generator or receiver in a subsequent procedure. The lead wires are then tunneled to the pocket designated for the pulse generator/receiver, where they are connected to complete the system setup.