Summary & Overview
CPT 63280: Cervical Intradural, Extramedullary Lesion Excision with Lamina Removal
CPT code 63280 covers surgical removal of an intradural, extramedullary lesion in the cervical spine with partial removal of the lamina and submission of tissue for pathology. This procedure is clinically significant because it addresses lesions that can compress neural structures, relieve symptoms, and provide diagnostic tissue. Nationally, utilization and payment for complex spine procedures influence hospital and surgical practice patterns and are a focus for surgical quality and utilization management.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical description of the service, common settings where the procedure is performed, and what typical billing practice elements are associated with the code. The publication highlights benchmarking context, expected site-of-service utilization, and policy considerations relevant to payer coverage and hospital billing workflows. It also summarizes clinical context for coding and documentation needs and flags areas where additional data would clarify utilization and authorization trends.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific reimbursement details.
Billing Code Overview
CPT code 63280 describes a surgical procedure in which the surgeon removes part of a cervical vertebral lamina (laminotomy/laminectomy) and excises an intradural, extramedullary lesion, with a portion of the lesion sent for pathological testing. Intradural indicates the lesion is located inside the dura mater; extramedullary indicates it lies outside the spinal cord substance.
Service Type: Surgical excision of intradural, extramedullary spinal lesion with partial cervical lamina removal
Typical Site of Service: Hospital inpatient or outpatient surgical suite (operating room)
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents with progressive neck pain, cervical radiculopathy, and signs of spinal cord compression (gait instability, hand weakness) found on neurological exam and cervical MRI. Imaging demonstrates an intradural, extramedullary enhancing mass at the C4–C5 level consistent with a suspected meningioma or nerve sheath tumor. After multidisciplinary review, the patient is scheduled for a posterior cervical laminectomy with microsurgical resection of the intradural, extramedullary lesion and intraoperative frozen section and permanent pathology sampling.
The clinical workflow: preoperative evaluation (neuroimaging, anesthesia assessment, informed consent), perioperative antibiotics and positioning in the operating room, a posterior midline cervical approach with hemilaminectomy or laminectomy at the involved level(s), durotomy, microsurgical tumor resection with neuromonitoring, specimen submission for frozen and permanent pathology, watertight dural closure and multilayer wound closure, immediate postoperative recovery in PACU, inpatient neurologic monitoring, postoperative imaging as indicated, and outpatient follow-up for pathology review and rehabilitation planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Placeholder — not used for billing purposes | Not applicable for reporting; reserved in list |
11 | Default reporting for a service | When no modifier is required and this is the primary procedure