2025 CPT code 63085
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Partial or complete vertebral corpectomy (vertebral body resection) via a transthoracic approach, with spinal cord and/or nerve root decompression; single thoracic segment.
Modifiers may be appended to 63085 as appropriate, including modifier 62 (two surgeons) and others as per current CPT guidelines.
Medical necessity for 63085 is established when conservative treatments (e.g., medication, physical therapy) have failed to alleviate neurologic symptoms caused by spinal cord compression from a thoracic vertebral lesion or stenosis. The procedure must be medically necessary to improve the patient's neurological function and quality of life.
The surgeon's responsibilities include performing the corpectomy, decompressing the spinal cord/nerve roots, and potentially performing or directing the spinal stabilization procedures.Post-operative care may also fall under the surgeon's responsibility. Anesthesiologist, nursing staff, and other support personnel are also involved.
In simple words: The surgeon removes part or all of a vertebra in the upper back through an incision in the chest to relieve pressure on the spinal cord and nerves.This may involve removing some of the discs and may require additional procedures to stabilize the spine.
This CPT code encompasses the surgical excision (removal) of all or a portion of a single thoracic vertebra using a transthoracic approach (through the anterior chest).The procedure includes decompression of the spinal cord and/or nerve roots at the affected level.A partial corpectomy, in the thoracic spine, is defined as the removal of at least one-third of the vertebral body. The procedure may involve removing adjacent intervertebral discs, and often necessitates spinal stabilization techniques (such as bone grafting and instrumentation) which are billed separately.
Example 1: A patient presents with severe thoracic spinal stenosis caused by degenerative disc disease and bone spurs. The surgeon performs a 63085 procedure to remove the compressed vertebral body and decompress the spinal cord.Spinal fusion is performed with bone graft and instrumentation (separately billed). , A patient experiences acute spinal cord compression secondary to a traumatic fracture of a thoracic vertebra.The surgeon performs 63085 to remove the fractured portion of the vertebra, decompresses the spinal cord and uses bone grafting and instrumentation for stabilization., A patient with a tumor impinging on the thoracic spinal cord undergoes a 63085 procedure. The surgeon removes the affected vertebra and tumor, decompresses the cord.Additional codes for tumor removal might apply. Postoperative radiation may be necessary.
Preoperative imaging (X-rays, CT, MRI) showing the spinal stenosis or lesion.Operative report detailing the surgical approach, extent of vertebral body resection, decompression techniques, and any additional procedures.Pathology report (if applicable).Postoperative imaging to confirm decompression and fusion (if performed).
** Thorough documentation of the surgical approach, extent of corpectomy, decompression techniques, and any associated procedures is critical for accurate coding and reimbursement.Consider consulting with a coding specialist for complex cases.
- Revenue Code: P1F (Major Procedure - Explor/Decompr/Excis Disc)
- RVU: The RVUs for this code vary based on geographic location and other factors.Consult the appropriate payer's fee schedule for current values.
- Global Days: The global period for this procedure varies depending on the complexity and extent of the surgery and any associated procedures.Check payer specific guidelines.
- Payment Status: Active
- Modifier TC rule: The TC modifier is not applicable to this code.
- Fee Schedule: Historical fee schedule data is not included here. Consult payer-specific historical data for relevant information.
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center