Summary & Overview
CPT 61450: Section/Decompression of Gasserian Ganglion for Trigeminal Neuralgia
CPT code 61450 identifies a neurosurgical cranial procedure that creates an opening below the temples to section or decompress the sensory root of the gasserian ganglion to treat trigeminal neuralgia. This is a high-acuity operative intervention used when medical management is insufficient; it has national relevance due to the substantial morbidity of untreated trigeminal neuralgia and the specialized resources required to deliver the service.
Key payers in the national coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the code, typical sites of service, and the payer set commonly analyzed for coverage and billing comparisons. The publication summarizes what to expect in benchmarking and policy review: common clinical indications, where the procedure is typically performed (hospital operating rooms or ambulatory surgical centers), and payer coverage considerations at a national level.
This summary is intended to orient clinicians, coding professionals, and policy analysts to the clinical purpose and service setting associated with CPT code 61450, and to highlight the payer universe referenced in the accompanying analysis. Data not available in the input will be noted where applicable in detailed sections.
Billing Code Overview
CPT code 61450 describes a neurosurgical procedure in which the surgeon creates an opening in the skull below the temples to section and apply or release pressure on the sensory root of the gasserian ganglion, a major nerve cluster at the root of the fifth cranial nerve. The procedure is performed primarily to treat trigeminal neuralgia, a severe facial nerve pain disorder.
Service type: Neurosurgical cranial procedure (trigeminal nerve surgery)
Typical site of service: Operating room in an acute care hospital or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 60-year-old female with medically refractory, severe right-sided trigeminal neuralgia causing lancinating facial pain despite trials of anticonvulsant therapy (e.g., carbamazepine) and percutaneous interventions. She is evaluated by a neurosurgeon and undergoes preoperative imaging (brain MRI with trigeminal nerve protocol) to rule out a compressive lesion. The procedure, a subtemporal craniotomy with sectioning or pressure/relief of the sensory root of the gasserian (trigeminal) ganglion, is performed in the operating room under general anesthesia. Intraoperative neurophysiologic monitoring may be used. The typical workflow includes preoperative consent and optimization, anesthesia induction, surgical exposure through an opening in the skull below the temples, identification of the trigeminal root/gasserian ganglion, sectioning or decompression as indicated, hemostasis, closure, and postoperative recovery with neurologic assessments. Postoperative outpatient follow-up assesses pain control, cranial nerve function, wound healing, and medication tapering as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal/standard service | Use when the surgeon performs the service as expected without unusual circumstances |
22 |