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Upper Back Cordotomy, One Side, Single Operation

Wisconsin 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 $4,074 · 10th to 90th $3,631 to $5,623Professionalmedian $6,166 · 10th to 90th $2,818 to $7,762
$2K$5Kfacility $4,074professional $6,166

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

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
None
Typical Low
$3,630.78
Median
$4,073.80
Typical High
$6,165.95
Cigna
Setting
Professional
Modifier
None
Typical Low
$2,290.87
Median
$5,370.32
Typical High
$6,165.95
Medica
Setting
Facility
Modifier
None
Typical Low
$3,801.89
Median
$5,011.87
Typical High
$5,011.87
Medica
Setting
Professional
Modifier
None
Typical Low
$7,762.47
Median
$7,762.47
Typical High
$7,762.47