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Official Description

Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Vertebral corpectomy is a surgical procedure that involves the removal of a vertebral body along with the intervertebral discs situated above and below the affected vertebra. This operation is specifically performed to excise an intraspinal lesion or tumor that is located within the spinal canal and is either within or extending into the dura mater, which is the protective covering of the spinal cord. The procedure is limited to a single segment of the lumbar or sacral spine, making it a targeted intervention for addressing localized spinal pathologies. The approach to the surgery can be either transperitoneal, which involves an incision in the abdomen and entry into the peritoneal cavity, or retroperitoneal, which requires a flank incision to access the spine from the side. During the operation, careful dissection is performed to protect vital structures surrounding the spine. The surgical team utilizes a microscope to enhance visibility and precision while removing the intervertebral discs and the vertebral body, allowing for thorough exploration and excision of the lesion or tumor. If the lesion is found to be within or extending into the dura, the dura is incised to facilitate complete removal. Post-excision, the dura is repaired, and additional procedures such as bone grafting and spinal instrumentation may be performed to ensure stability and promote healing in the affected area.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The vertebral corpectomy procedure is indicated for the following conditions:

  • Intraspinal Lesion - The presence of a tumor or lesion located within the spinal canal that requires excision.
  • Intradural Tumor - Tumors that are situated within the dura mater, necessitating surgical intervention for removal.
  • Single Segment Pathology - Conditions affecting a single segment of the lumbar or sacral spine that warrant targeted surgical resection.

2. Procedure

The vertebral corpectomy procedure involves several critical steps to ensure effective removal of the lesion while maintaining spinal stability:

  • Step 1: Approach Selection - The surgeon determines the appropriate surgical approach, either transperitoneal or retroperitoneal, based on the location of the lesion and the patient's anatomy. The transperitoneal approach involves making an incision in the abdomen and entering the peritoneal cavity, while the retroperitoneal approach requires a flank incision to access the spine from the side.
  • Step 2: Exposure of the Affected Segment - Once the approach is established, surrounding tissues are carefully dissected to expose the affected lumbar or sacral segment. This step is performed with caution to protect vital structures in the vicinity.
  • Step 3: Removal of Intervertebral Discs - The intervertebral discs located above and below the vertebral body are removed first. This is done using a surgical microscope to enhance visibility and precision, allowing for careful dissection from surrounding tissues.
  • Step 4: Excision of the Vertebral Body - After the discs are removed, the vertebral body is excised. The surgeon identifies and explores the lesion or tumor within the spinal canal, assessing its relationship to the surrounding structures.
  • Step 5: Dural Incision and Lesion Removal - If the lesion is determined to be within or extending into the dura, the dura mater is incised. The lesion is then meticulously dissected free from surrounding tissues with the aid of an operating microscope and removed.
  • Step 6: Dural Repair - Following the excision of the lesion, the dura is repaired using sutures or a dural graft to restore the protective covering of the spinal cord.
  • Step 7: Bone Grafting and Fusion - Separately reportable bone grafting and fusion procedures are performed to support the anterior aspect of the spine where the discs and vertebral body have been removed. The surrounding bone is contoured to facilitate the placement of the graft and ensure proper fusion with adjacent bone.
  • Step 8: Spinal Instrumentation - If necessary, separately reportable spine instrumentation may be utilized to stabilize the spine following the removal of the vertebral body and discs.

3. Post-Procedure

Post-procedure care for patients undergoing vertebral corpectomy includes monitoring for any complications related to the surgery, such as infection or cerebrospinal fluid leaks. Patients are typically advised on pain management strategies and may require physical therapy to aid in recovery. The expected recovery period can vary based on individual patient factors and the extent of the surgery performed. Follow-up appointments are essential to assess healing and the effectiveness of the intervention, as well as to monitor for any recurrence of the lesion or tumor.

Short Descr REMOV VERT IDRL BDY LMBR/SAC
Medium Descr VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR
Long Descr Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures

This is a primary code that can be used with these additional add-on codes.

22840 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)
22841 Addon Code MPFS Status: Bundled Code APC C Physician Quality Reporting CPT Assistant Article Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure)
22842 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)
22843 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)
22844 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for primary procedure)
22845 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
22846 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)
22847 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure)
22848 Addon Code MPFS Status: Active Code APC N Physician Quality Reporting CPT Assistant Article Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)
22853 CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)
22854 CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
22859 CPT Add On CPT Resequenced MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
63308 Addon Code MPFS Status: Active Code APC C CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segment)
69990 Addon Code MPFS Status: Restricted APC N ASC N1 PUB 100 CPT Assistant Article 1Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
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2013-01-01 Changed Short Descriptor changed.
Pre-1990 Added Code added.
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