Summary & Overview
CPT 62264: Epidural Neurolysis (Racz Catheter) for Adhesion Lysis
CPT code 62264 represents epidural neurolysis (commonly called a Racz catheter procedure), a targeted interventional pain treatment in which a catheter or chemical agent is placed in the epidural space under imaging guidance to disrupt adhesions. The code captures procedures performed across multiple sessions on the same day and is used in managing refractory epidural adhesions that contribute to chronic radicular pain. Nationally, this procedure is important because it bridges conservative care and more invasive spinal surgery, often influencing utilization and cost patterns for chronic spine pain.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing overview of the procedure, common places of service, and the elements that affect coding and payment. The publication summarizes typical billing contexts, highlights common modifiers used with this service (where provided), and outlines where clinicians and billing staff should confirm documentation and imaging support. The content also presents benchmarks and policy-relevant considerations affecting coverage and reimbursement, and provides clinical context to help payers and providers align coding with the intended service. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 62264 describes an epidural neurolysis (Racz catheter) procedure in which a provider places a catheter or introduces a chemical agent into the epidural space to lyse adhesions. The procedure uses imaging guidance to identify the adhesion site and is performed over more than one session on the same day.
Service type: Therapeutic interventional pain procedure (epidural adhesion lysis)
Typical site of service: Hospital outpatient department, ambulatory surgery center, or interventional pain clinic with imaging capabilities
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient with chronic post-laminectomy lumbar radiculopathy presents with persistent neuropathic leg pain and imaging-confirmed epidural adhesions causing tethering of nerve roots. Conservative management including oral analgesics, physical therapy, and epidural steroid injections produced only transient relief. The interventional pain physician schedules an epidural neurolysis (Racz catheter) under fluoroscopic guidance. In the interventional suite the patient is prepped and positioned prone. Conscious sedation is administered. Using imaging, the provider introduces a Racz catheter into the epidural space, navigates to areas of scar/adhesion, and performs mechanical adhesiolysis with catheter manipulation combined with injection of local anesthetic, saline, and steroid solutions; a chemical lysis agent may be instilled if indicated. The procedure requires more than one catheter manipulation/instillation session during the same day to achieve adequate distribution and adhesion disruption. Post-procedure monitoring occurs in recovery with neurologic checks, and discharge instructions address activity limitations, analgesic use, and signs of complications (e.g., infection, worsening neurologic deficit). Typical site of service is an ambulatory surgery center or hospital outpatient department. The service type is an image-guided, minimally invasive interventional pain procedure (epidural adhesiolysis/ neurolysis).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Unrelated evaluation and management service by the same physician on the same day |