Selecting the Right CPT Code for Lumbar Spinal Decompression Surgery

Selecting the correct CPT code for lumbar decompression surgery depends primarily on the surgical approach and method of visualization. Report CPT 62330 for percutaneous image-guided decompression with indirect visualization, CPT 63047 for open lumbar decompression with direct visualization, and CPT 62380 for endoscopic decompression performed under continuous direct visualization.

Lumbar decompression surgery is done to relieve pressure on the spinal cord or spinal nerves in the lower back to relieve or reduce pain and/or numbness, and improve mobility. This compression is caused by conditions such as herniated disks, spinal stenosis, or spondylolisthesis. Decompression surgery increases space in the spinal canal or neural foramen by removing or trimming parts of the vertebrae, ligaments, or disk material, to reduce the pressure on the spinal cord and nerve roots.

There are 3 different approaches used for lumbar decompression surgery. These include:

• A minimally invasive procedure using percutaneous approach with indirect visualization
• An open approach using direct visualization
• An endoscopic approach where instruments are passed through the scope to perform the procedure.
  
  

CPT Definitions of Approach and Method of Visualization

When reporting lumbar decompression procedures, approach and method of visualization are primary differentiators in CPT code selection. For purposes of CPT coding, the following definitions of approach and method of visualization apply to spinal procedures. The primary approach and method of visualization define the service, whether another method is incidentally applied. Surgical services are presumed open, unless otherwise specified.

Approach:

• Percutaneous: Image-guided procedures (eg, computer tomography (CT) or fluoroscopy) performed through a surgical incision with indirect visualization of the spine and without the use of any device that allows visualization through a surgical incision
• Endoscopic: Spinal procedures performed with continuous direct visualization of the spine through an endoscope
• Open: Spinal procedures performed with continuous direct visualization of the spine through a surgical opening

Method of Visualization:

• Indirect visualization: Image-guided (eg, CT or fluoroscopy), not light-based visualization
• Direct visualization: Light-based visualization. Can be performed by the naked eye, or with surgical loupe, microscope, or endoscope

Lumbar Decompression CPT Code Descriptions

62330 (previously 0275T): Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lumbar:

CPT 62330 is a minimally invasive procedure performed via a percutaneous approach under indirect vision. No device is used for visualization through surgical incision. A small incision is made and a cannula inserted. Ligamentum flavum and small pieces of vertebral lamina are resected, and tissue and bone sculpting are performed under radiological guidance. Closure of the wound is minimal and could be closed with just steri-strips being applied.

You may see this called a percutaneous image-guided lumbar decompression (PILD).

Report 62331 one time for additional interspaces

Image courtesy of https://aneskey.com/minimally-invasive-lumbar-decompression-mild-procedure/

63047: Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (eg, spinal or lateral recess stenosis), single vertebral segment; lumbar

CPT 63047 uses an open approach with direct visualization of the spine. With the patient prone, a midline incision overlying the affected vertebrae is made. Fascia is incised and paravertebral muscles are retracted. Spinous processes are removed with ronguers. If the stenosis is central, the lamina out to the articular facets are removed using a burr. If the stenosis is in the lateral recess, only half of the lamina is removed. Nerve root canals are freed by additional resection of the facet and compression is relieved by removal of any bony or tissue overgrowth around the foramen.

Report 63048 for each additional vertebral segment

Image courtesy of https://www.researchgate.net/figure/Schematic-lumbar-spinal-stenosis-associated-with-degenerative-spondylolisthesis-and-open_fig1_353536326

62380: Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar

CPT 62380 uses an endoscope inserted into a small incision and provides direct visualization of the spine structures and tissues and instruments are passed through the scope to perform the procedure. The endoscope is placed through the foramen and into the spinal canal. Surgical instruments are advanced through the endoscope and herniated disc fragments are removed and the disc is sculpted to eliminate the pressure on the nerve roots.

Image courtesy of https://onlinelibrary.wiley.com/doi/full/10.1111/os.12907

Sample Documentation

Spinal decompression surgery is a procedure aimed at relieving pressure on the spinal cord or nerves due to conditions such as herniated discs or spinal stenosis. It aims to alleviate pain, improve mobility, and enhance the quality of life for patients suffering from spinal conditions. Coding these procedures can be difficult. When making code selections, the main thing to consider is what type of approach was used (percutaneous, open or endoscopic) and whether visualization was direct or indirect with image-guidance.

FAQ

References

• CPT Assistant, March 2026, Volume 36, Issue 3, page 15
• CPT Assistant, February 2017, Volume 27, Issue 2, page 12
• CPT Code Manual CPT Copyright © 2025 American Medical Association.

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The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.