2025 CPT code 63650
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Percutaneous implantation of a neurostimulator electrode array in the epidural space.
Modifiers may be applicable depending on the circumstances of the procedure.Refer to the CPT manual and payer specific guidelines for more information.
Medical necessity for spinal cord stimulation is established based on a diagnosis of chronic neuropathic pain that is refractory to conservative medical management (such as medications, physical therapy, injections).The patient must demonstrate a positive response to a trial period of stimulation to justify permanent implantation.
The physician is responsible for performing the percutaneous implantation, including the placement of the electrode array, connection to the neurostimulator, and confirmation of proper electrode placement via testing and stimulation. Post-operative care and follow-up are also the physician's responsibility.
In simple words: This code covers a procedure where a doctor inserts thin wires (electrodes) through the skin into the space around the spinal cord to relieve pain.These wires are connected to a device outside the body that sends mild electrical signals to help manage pain and muscle spasms. The procedure uses live X-ray imaging (fluoroscopy).
This CPT code describes the percutaneous implantation of a neurostimulator electrode array into the epidural space.The procedure involves inserting electrodes through the skin, under fluoroscopic guidance, to deliver electrical impulses that alleviate pain and reduce muscle spasms.The electrodes are connected to an external neurostimulator, which is programmed to deliver the appropriate electrical stimulation.This code encompasses both temporary and permanent implantation of the electrode array.Fluoroscopic guidance is inherent to the procedure and not separately reported.
Example 1: A patient with chronic lower back pain refractory to conservative management undergoes percutaneous implantation of a trial spinal cord stimulator electrode array. The physician performs the procedure under fluoroscopic guidance, checking for paresthesias to ensure correct electrode placement., A patient with failed back surgery syndrome experiences significant relief during a trial of spinal cord stimulation.The physician proceeds with permanent implantation of the neurostimulator electrode array using code 63650., A patient with complex regional pain syndrome (CRPS) is a candidate for spinal cord stimulation. The physician performs a percutaneous implantation of the electrode array, aiming for precise placement at the appropriate level in the epidural space for optimal pain management.
* Pre-operative assessment including history, physical examination, and imaging studies.* Detailed documentation of the procedure, including the number and location of electrodes implanted, and impedance measurements.* Post-operative care instructions and pain management plan.* Patient's response to the stimulation during the trial period, if applicable.* Evidence of medical necessity, including documentation of failed conservative treatment strategies.
** This code does not include the costs associated with the neurostimulator device or other related components.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: 7.15 (2024)
- Global Days: 10 days
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Fee schedule data varies based on payer and location.Check with specific payers for historical data.
- Specialties:Neurosurgery, Pain Management, Anesthesiology
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)