Summary & Overview
CPT 63287: Thoracolumbar Intradural Intramedullary Lesion Excision
CPT code 63287 covers surgical excision of an intradural, intramedullary spinal cord lesion in the thoracolumbar region with partial removal of the lamina and submission of tissue for pathology. This code captures high-complexity neurosurgical care that typically occurs in hospital operating rooms or ambulatory surgery centers and has significant implications for specialty reimbursement, utilization management, and surgical quality measurement nationwide. Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will gain a clinical and operational understanding of the procedure tied to CPT code 63287, including typical settings of care, common payer coverage considerations, and where this service sits in neurosurgical practice. The publication summarizes national benchmarking context, relevant coding considerations, and clinical context for use of this code — for example, the intra-dural and intra-medullary nature of the lesion, the need for tissue submission for pathology, and the thoracolumbar anatomic focus. Data not available in the input is explicitly noted where applicable in the full publication.
Billing Code Overview
CPT code 63287 describes a surgical procedure in which the provider performs a laminectomy of the thoracolumbar spine and excises an intradural, intramedullary lesion of the spinal cord, sending a portion of the removed tissue for pathological testing. Intradural indicates the procedure is performed within the dura mater, and intramedullary indicates the lesion is within the spinal cord substance.
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Service type: Surgical excision of intradural, intramedullary spinal cord lesion with partial laminectomy
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Typical site of service: Hospital operating room or ambulatory surgery center specializing in neurosurgical procedures
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents with progressive lower extremity weakness, sensory changes and gait instability over several months. Magnetic resonance imaging of the thoracic spine reveals an intradural intramedullary lesion at the T8–T9 level consistent with a spinal cord tumor (e.g., ependymoma, astrocytoma). After neurosurgical consultation, the patient is scheduled for a thoracic laminectomy and microsurgical excision of the intradural intramedullary tumor. Intraoperative neurophysiologic monitoring is performed. The surgeon removes a portion of the lamina (laminotomy/laminectomy) to access the dura, opens the dura, performs a myelotomy to reach the intramedullary lesion, debulks and excises the tumor, and sends representative tissue for histopathology and possible molecular testing. Postoperative workflow includes recovery in a monitored setting, neurologic exams, pain management, possible short-term intensive care observation for airway and neurologic stability, and planned inpatient rehabilitation or outpatient physical therapy depending on deficits. Typical site of service: hospital operating room (inpatient or outpatient hospital setting depending on admission status). Service type: major operative neurosurgical procedure under general anesthesia with intraoperative monitoring and specimen submission for pathology.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default (no modifier) | Use when no other modifier applies and service is billed normally |