CPT 63267 Laminectomy Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 63267: Lumbar Extradural Lesion Evacuation via Laminectomy

CPT code 63267 denotes surgical removal or evacuation of an extradural (epidural) growth in the lumbar spine performed via a laminectomy. This procedure is an important neurosurgical and orthopedic spine service used to relieve compression, remove tumor or mass, and restore neurologic function. Nationally, lumbar extradural lesion resections are significant for hospitals and surgical practices because they involve operative resources, potential inpatient stays, and multidisciplinary perioperative care.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, payer coverage considerations, and benchmarks when available. The publication summarizes coding intent, typical settings of care, and common billing modifiers used with this type of operative spinal procedure. It also outlines what to expect in terms of typical sites of service and clinical indications for lumbar extradural lesion evacuation.

This piece serves clinicians, coding professionals, and policy analysts seeking a focused reference on CPT code 63267, including clinical scope, payer landscape, and where to look for more detailed reimbursement or utilization data. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 63267lumbar spine surgerylaminectomyspinal decompressionneurosurgeryoperative proceduresurgical oncologyhospital inpatientoutpatient surgery

Billing Code Overview

CPT code 63267 describes surgical removal or evacuation of an extradural (epidural) growth in the lumbar spine performed through a laminectomy approach to access the lesion. This procedure is a spinal decompression and tumor/lesion resection performed on the lumbar vertebral segment.

Service type: Surgical excision/evacuation of extradural spinal lesion via laminectomy
Typical site of service: Hospital inpatient or outpatient operating room, commonly within the neurosurgery or orthopedic spine surgical setting

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient presents with progressive low back pain, radiating leg weakness, and neurogenic claudication refractory to conservative care. MRI of the lumbar spine demonstrates an extradural mass compressing the thecal sac at L3–L4 with associated foraminal stenosis. The neurosurgeon schedules a lumbar laminectomy with excision/evacuation of the extradural growth under general anesthesia. Preoperative workflow includes history and physical, informed consent discussing risks (bleeding, infection, dural tear, neurologic deficit), preop labs and anesthesia evaluation. Intraoperative workflow includes prone positioning, fluoroscopic level confirmation, midline incision, muscle dissection, laminectomy at the affected level(s), microsurgical evacuation or resection of the extradural lesion, hemostasis, possible facetectomy or foraminotomy if nerve root decompression is required, and layered closure. Postoperative care includes PACU monitoring, pain control, wound checks, postoperative imaging if indicated, and a short inpatient stay for neurologic observation and mobilization with physical therapy as needed.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased Procedural Services	Use when work, time, or complexity substantially exceeds typical for `63267` and documented justification is provided.

CPT 63273: Sacral Laminectomy with Intradural Lesion Excision

CPT-63265-CERVICAL-EXTRADURAL-GROWTH-REMOVAL-LAMINECTOMY

CPT 63265: Cervical Extradural Growth Removal via Laminectomy

CPT-63283-SACRAL-LAMINA-INTRADURAL-LESION-EXCISION

CPT 63283: Sacral Laminectomy with Intradural Lesion Excision

CPT-63275-CERVICAL-EXTRADURAL-SPINAL-LESION-EXCISION-PARTIAL-VERTEBRECTOMY

CPT 63275: Cervical Extradural Spinal Lesion Excision, Partial Vertebrectomy

CPT-63280-CERVICAL-INTRADURAL-EXTRAMEDULLARY-LESION-EXCISION-LAMINA-REMOVAL

CPT 63280: Cervical Intradural, Extramedullary Lesion Excision with Lamina Removal

CPT-63250-CERVICAL-SPINAL-AVM-OBLITERATION

CPT 63250: Cervical Spinal Arteriovenous Malformation Obliteration

CPT-63277-LUMBAR-EXTRADURAL-LESION-EXCISION-LAMINECTOMY

CPT 63277: Lumbar Extradural Lesion Excision with Vertebral Resection

CPT-63276-THORACIC-EXTRADURAL-LESION-EXCISION

CPT 63276: Excision of Thoracic Extradural Spinal Lesion

CPT-63268-SACRAL-SPINE-EXTRADURAL-GROWTH-LAMINECTOMY

CPT 63268: Sacral Spine Extradural Growth Removal via Laminectomy

CPT-63270-CERVICAL-INTRADURAL-TUMOR-RESECTION-LAMINECTOMY

CPT 63270: Cervical Intradural Tumor Resection via Laminectomy

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Taxonomy Code	Specialty	Notes
`207RE0100X`	Orthopaedic Surgery of the Spine	Orthopaedic spine surgeons commonly perform lumbar laminectomy and extradural mass excision.
`2084P0800X`	Neurological Surgery	Neurosurgeons frequently perform laminectomy with resection of extradural lesions.
`2080S0122X`	General Surgery (Spine Subspecialty)	Some general surgeons with spine specialization may perform decompressive spinal procedures.
`207K00000X`	Orthopaedic Surgery	General orthopaedic surgeons involved in spine procedures in certain systems.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M51.27`	Other intervertebral disc displacement, lumbar region	Lumbar disc pathology can coexist or mimic extradural mass symptoms and may be addressed during decompression.
`M48.06`	Spinal stenosis, lumbar region	Lumbar extradural lesions can produce spinal canal stenosis requiring decompression via laminectomy.
`C79.31`	Secondary malignant neoplasm of bone, lumbar vertebra and pelvis	Metastatic extradural spinal tumors commonly present with cord or nerve root compression prompting laminectomy and tumor debulking.
`D33.4`	Benign neoplasm of spinal cord, lumbar region	Benign spinal neoplasms in the extradural space may require surgical excision.
`G55.9`	Nerve root and plexus compressive dysfunction, unspecified	Clinical presentation of radiculopathy from extradural compression often leads to surgical decompression.
`M54.16`	Radiculopathy, lumbar region	Symptom code commonly associated with lumbar nerve compression targeted by laminectomy and lesion evacuation.
`M51.26`	Other intervertebral disc displacement, lumbosacral region	Related lumbar pathology that may be addressed concurrently with extradural lesion removal.
`R25.2`	Cramp and spasm	May be a symptom representation leading to diagnostic evaluation and eventual surgical management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`22612`	Arthrodesis, posterior or posterolateral technique, single level; lumbar	May be performed if spinal instability is created/identified during or after laminectomy requiring fusion.
`63030`	Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; single interspace, lumbar	Used for focal nerve-root decompression; may be an alternative or adjunct to `63267` when addressing disc herniation rather than an extradural mass.
`63275`	Laminectomy with excision of intraspinal lesion other than neoplasm, lumbar	Related when the lesion is intradural or intramedullary rather than extradural; differentiates operative approach and coding.
`69990`	Microsurgical techniques, requiring use of an operating microscope (List separately in addition to code for primary procedure)	May be reported when microsurgical magnification is used during `63267` if guidelines permit.
`77002`	Fluoroscopic guidance for spinal level localization (e.g., intraoperative fluoroscopy)	Often used intraoperatively to confirm level prior to performing the laminectomy and should be billed when appropriate.

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