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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 July 2026.

Facilitymedian $2,951 · 10th–90th $1,622$5,0120%20%10th90th$2,951Professionalmedian $7,762 · 10th–90th $7,762$7,7620%50%$7,762$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5,495.41
Median
$5,495.41
Typical High
$6,606.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$5,011.87
Typical High
$5,248.07
Medica
Setting
Professional
Modifier
Global
Typical Low
$7,762.47
Median
$7,762.47
Typical High
$7,762.47
United
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$2,818.38
Typical High
$3,090.30