2025 CPT code 63035
(Active) Effective Date: N/A Revision Date: N/A Surgery - Posterior Extradural Laminotomy or Laminectomy Surgical Procedures on the Nervous System Feed
Laminotomy (hemilaminectomy) with nerve root decompression, including partial facetectomy, foraminotomy, and/or herniated disc excision; each additional cervical or lumbar interspace.
Modifier 50 (bilateral procedure) is not appropriate for 63035; report twice if bilateral.Other modifiers may be applicable depending on the circumstances (e.g., 59 for distinct procedural service).
Medical necessity is established by the presence of clinically significant symptoms directly correlating with nerve root compression demonstrable on imaging.Conservative treatment failure should be documented.
The neurosurgeon or orthopedic spine surgeon is responsible for performing the laminotomy, decompression, facetectomy, foraminotomy, and/or discectomy. Post-operative care and follow-up are also the responsibility of the surgeon.
In simple words: This code describes an additional surgery to remove part of a bone in the spine (lamina) to relieve pressure on a nerve.It's done if more than one area of the spine needs this type of surgery. This surgery may involve removing small parts of other bones in the spine and/or a herniated disc.
This CPT code, 63035, represents a laminotomy (hemilaminectomy), which involves removing portions of adjacent laminae to decompress nerve roots.The procedure includes a partial facetectomy, foraminotomy, and/or excision of a herniated intervertebral disc. It applies to each additional cervical or lumbar interspace beyond the initial one, requiring separate reporting in addition to the primary procedure code (63020 or 63030).Both open and endoscopic approaches are encompassed.
Example 1: A patient presents with L4-L5 radiculopathy due to a herniated disc.A laminotomy at L4-L5 is performed (63030).During surgery, additional nerve root compression at L5-S1 is discovered requiring an additional laminotomy (63035). , A patient with multi-level cervical spondylosis undergoes an anterior cervical discectomy and fusion (ACDF) at C5-C6.Post-operatively, significant C6-C7 nerve root compression is noted.A subsequent posterior laminotomy at C6-C7 (63035) is performed., A patient with lumbar spinal stenosis undergoes a laminectomy at L3-L4 and L4-L5 (63030). During the surgery, the surgeon identifies significant stenosis at L5-S1 requiring a laminotomy (63035) to address additional nerve root compression.
Preoperative imaging (MRI, CT), operative report detailing the levels, techniques used (open or endoscopic), and structures addressed.Postoperative imaging may be beneficial, depending on the complexity of the case.
** This code is an add-on code, meaning it's reported in addition to a primary code (63030 or 63020) for the initial level of the laminotomy.Accurate documentation is critical for appropriate reimbursement.Payer-specific coding policies should always be consulted.
- Revenue Code: P1F (Major Procedure - Exploration/Decompression/Excision Disc)
- Payment Status: Active
- Modifier TC rule: Not applicable
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center