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Upper Back Cordotomy, One Side, Single Operation

Utah 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.

Professionalmedian $2,951 · 10th–90th $1,230$4,7860%20%10th90th$2,951$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Molina
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$4,677.35
Typical High
$4,786.30
United
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,445.44
Typical High
$2,951.21