Upper Back Cordotomy, One Side, Single Operation

Missouri rates for HCPCS 63195

Surgery for severe pain that has not responded to other treatment. Part of the bony arch of a vertebra in the chest section of the spine is removed to reach the spinal cord, and the pain-carrying pathway is cut on one side of the cord, relieving pain on the opposite side of the body. It is completed in a single operation.

Rates data updated October 2026.

How much rates vary

Facilitymedian $5,012 · 10th to 90th $5,012 to $5,248Professionalmedian $7,762 · 10th to 90th $7,762 to $7,762

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Medica Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,248.07	Facility	None	$5,011.87	$5,011.87	$5,248.07
Medica Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47	Professional	None	$7,762.47	$7,762.47	$7,762.47