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CPT®
64761

CPT® Code 64761
Deleted

Official Description

Transection or avulsion of; pudendal nerve

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The pudendal nerve plays a crucial role in controlling sensation in the perineal region, which includes the area between the genitals and the anus, the rectum, and the external genitalia. Transection or avulsion of the pudendal nerve is a surgical procedure aimed at alleviating chronic pain that may arise from various conditions affecting this nerve. During the procedure, the surgeon carefully exposes and isolates the pudendal nerve to ensure precision and minimize damage to surrounding tissues. Transection involves the surgical division of the nerve, which can be achieved by grasping the nerve and cutting it. In some cases, avulsion may be performed by twisting the nerve over a hemostat, effectively detaching it from its surrounding structures. Alternatively, the procedure may involve stretching the nerve, ligating it, and then dividing it first at the distal end followed by the proximal end, allowing the proximal segment of the nerve to retract into deeper tissues. After the nerve has been transected or avulsed, the soft tissues surrounding the area are meticulously closed in layers to promote healing and restore anatomical integrity.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The transection or avulsion of the pudendal nerve is indicated for specific conditions that result in chronic pain in the perineal region. The following are the primary indications for this procedure:

  • Chronic Pelvic Pain This procedure is often performed to address persistent pelvic pain that has not responded to conservative treatments.
  • Pudendal Neuralgia Patients suffering from pudendal neuralgia, characterized by pain in the distribution of the pudendal nerve, may benefit from this surgical intervention.
  • Neuropathic Pain Syndromes Conditions involving neuropathic pain that affect the perineal area may warrant the need for nerve transection or avulsion.

2. Procedure

The procedure for transection or avulsion of the pudendal nerve involves several critical steps to ensure effective treatment while minimizing complications. The following outlines the procedural steps:

  • Step 1: Exposure and Isolation The surgeon begins by making an incision to access the pudendal nerve. Careful dissection is performed to expose and isolate the nerve from surrounding tissues, ensuring that the nerve is clearly visible for the subsequent steps.
  • Step 2: Transection of the Nerve Once the pudendal nerve is adequately exposed, the surgeon grasps the nerve and performs transection by dividing it. This step is crucial as it interrupts the nerve's ability to transmit pain signals.
  • Step 3: Avulsion of the Nerve In some cases, the surgeon may choose to avulse the nerve. This is done by twisting the nerve over a hemostat, effectively detaching it from its surrounding structures, which can further alleviate pain.
  • Step 4: Alternative Technique Alternatively, the surgeon may opt to stretch the nerve, ligate it, and then divide it first at the distal end followed by the proximal end. This technique allows the proximal end of the nerve to retract into deeper tissues, further reducing the potential for pain transmission.
  • Step 5: Closure of Soft Tissues After the nerve has been transected or avulsed, the surgeon meticulously closes the surrounding soft tissues in layers. This layered closure is essential for proper healing and restoration of the anatomical structure.

3. Post-Procedure

Post-procedure care following transection or avulsion of the pudendal nerve involves monitoring for any complications and managing pain. Patients may experience some discomfort as they recover, and appropriate pain management strategies should be implemented. Follow-up appointments are essential to assess healing and the effectiveness of the procedure in alleviating chronic pain. Additionally, patients may be advised on activity restrictions and rehabilitation exercises to support recovery and improve outcomes.
Short Descr INCISION OF PELVIS NERVE
Medium Descr TRANSECTION/AVULSION PUDENDAL NERVE
Long Descr Transection or avulsion of; pudendal nerve
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) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures
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Notes
2015-01-01 Deleted Code deleted
Pre-1990 Added Code added.
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