2025 CPT code 63267
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Laminectomy for excision or evacuation of extradural spinal lesion (other than neoplasm); lumbar.
Modifiers may be applicable based on specific circumstances (e.g., 59 for distinct procedural service, 78 for unplanned return to OR). Consult CPT guidelines for modifier usage.
Medical necessity is established by symptoms consistent with nerve root compression (pain, weakness, numbness) and imaging demonstrating an extradural lesion causing significant compression.Conservative treatment failure should be documented.
The surgeon is responsible for all aspects of the procedure, from patient preparation and anesthesia to incision, dissection, lesion removal, hemostasis, and wound closure.
In simple words: The doctor removes a portion of the bone (lamina) in the lower back to reach and remove an abnormal growth outside the spinal cord's protective covering. This relieves pressure on the nerves.
This procedure involves a laminectomy to access and remove or evacuate an extradural lesion in the lumbar spine.The patient is prepped, anesthetized, and positioned prone. An incision is made over the lumbar lesion, and dissection proceeds through the tissues to expose the spinal cord.Retraction of muscles and soft tissues allows access. A portion of the lamina of the lumbar vertebra is removed. The extradural lesion is located on the dura, excised or evacuated, and any excess fluid or blood is drained. The wound is closed in layers.
Example 1: A 60-year-old patient presents with chronic lower back pain radiating down the leg, weakness, and numbness. Imaging reveals spinal stenosis and an extradural cyst compressing the nerve root.A laminectomy with cyst removal is performed., A 72-year-old patient with a history of spinal arthritis experiences sudden, severe lower back pain after lifting a heavy object.An MRI shows an extradural hematoma.Emergency laminectomy and hematoma evacuation are performed., A 45-year-old patient with a history of trauma to the lumbar spine develops an extradural granuloma.Laminectomy is performed for granuloma excision to alleviate nerve compression.
Preoperative imaging (MRI, CT), operative report detailing the extent of laminectomy, lesion characteristics, and hemostasis, pathology report (if applicable), postoperative neurological examination.
** This code is for extradural lesions, excluding neoplasms.For neoplasms, separate coding is required.The extent of the laminectomy should be documented appropriately.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Information not available in source.Consult current RVU data from CMS.
- Global Days: Information not available in source.Consult current CPT guidelines for global surgical periods.
- Payment Status: Active
- Modifier TC rule: Not applicable.The code represents the entire procedure.
- Fee Schedule: Information not available in source.Consult historical CPT fee schedules and Medicare payment data.
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center