Chapter 3 / Spine, spinal cord and peripheral nerves

There are a large number of codes covering most clinical situations for spinal surgery. The various codes for spinal decompression, removal of disc fusion and instrumentation should be used singly and not combined except in very unusual circumstances.

Spinal fusion includes bone grafting and this should not be charged separately.

Spinal decompression includes removal of disc matter and rhizolysis. These should not be charged separately.

Spinal surgery is frequently multi-level. Multiple level surgery does not constitute a multiple procedure and will not be reimbursed as such except in the cervical region.

Chemonucleolysis includes discography and this should not be charged separately.

Codes V4100, V4120 and V4000 are for treatment where the primary pathology is idiopathic adolescent scoliosis. They are not for any other purpose and specifically not for correction of degenerative scoliosis.

The code for Posterior Lumbar Interbody Fusion is V3362 and the narrative has been amended to reflect this.


3.1 - Spinal column (including intervertebral discs)

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information



Cervical region

A5291 Transforaminal Epidural (Cervical) Intermediate £285.00 £0.00 Show arrow
A5292 Transforaminal Epidural (Thoracic) Intermediate £285.00 £0.00 Show arrow
A5293 Transforaminal Epidural (Lumbar) Intermediate £285.00 £0.00 Show arrow
A5294 Transforaminal Epidural (Caudal) Intermediate £285.00 £0.00 Show arrow
V2200 Posterior decompression +/- foraminotomy - cervical region (1 or 2 levels) Complex £1,200.00 £440.00 Show arrow
V2282 Prosthetic intervertebral disc replacement - cervical region (1 or 2 levels) Complex £1,300.00 £825.00 Show arrow
V2300 Revisional posterior decompression +/– foraminotomy (cervical region) Complex £1,300.00 £440.00 Show arrow
V2990 Open door laminoplasty of the cervical region (Hirobyashi) Complex £1,200.00 £440.00 Show arrow
V3720 Posterior fusion +/- instrumentation - cervical region (1 or 2 levels) Xmajor £1,000.00 £440.00 Show arrow
V2900 Anterior discectomy - cervical region (1 or 2 levels) Xmajor £1,000.00 £440.00 Show arrow
V2902 Revisional anterior discectomy (cervical region) Complex £1,300.00 £495.00 Show arrow
V2950 Anterior discectomy, decompression and fusion (including bone grafting) - cervical region (1 or 2 levels) Complex £1,200.00 £495.00 Show arrow
V2980 Combined anterior and posterior fusion of cervical spine Complex £1,600.00 £550.00 Show arrow
V3730 Trans oral surgery including posterior fixation Complex £1,600.00 £495.00 Show arrow
V3721 Posterior fusion +/- instrumentation - cervical region (3 or more levels) Xmajor £1,000.00 £440.00 Show arrow
V2901 Anterior discectomy - cervical region (3 or more levels) Xmajor £1,000.00 £440.00 Show arrow
V2201 Posterior decompression +/- foraminotomy - cervical region (3 or more levels) Complex £1,200.00 £440.00 Show arrow
V2283 Prosthetic intervertebral disc replacement - cervical region (3 or more levels) Complex £1,300.00 £825.00 Show arrow
V2951 Anterior discectomy, decompression and fusion (including bone grafting) - cervical region (3 or more levels) Complex £1,200.00 £495.00 Show arrow
Thoracic region

V2402 Posterior decompression (thoracic region) Xmajor £1,200.00 £440.00 Show arrow
V2400 Posterior decompression with fusion (thoracic region) Complex £1,200.00 £440.00 Show arrow
V2430 Revisional posterior decompression with fusion (thoracic region) Complex £1,300.00 £440.00 Show arrow
V3120 Transthoracic/antero-lateral excision of intervertebral disc +/– fusion Complex £1,300.00 £440.00 Show arrow
V3122 Revisional transthoracic/antero-lateral excision of intervertebral disc +/– fusion Complex £1,600.00 £1,100.00 Show arrow
V3140 VATS percutaneous discectomy +/– fusion (thoracic region) Xmajor £600.00 £275.00 Show arrow
V3100 Combined anterior discectomy and posterior fusion (thoracic region) Complex £1,300.00 £440.00 Show arrow
V3102 Revisional combined anterior discectomy and posterior fusion (thoracic region) Complex £1,600.00 £1,100.00 Show arrow
V3181 Prosthetic intervertebral disc replacement in the thoracic spine Complex £1,300.00 £825.00 Show arrow
Lumbar region

V2540 Posterior excision of disc prolapse (including microdiscectomy +/- decompression) - lumbar region (1 or 2 levels) Xmajor £900.00 £275.00 Show arrow
V2544 Revision of posterior excision of disc prolapse (lumbar region) Complex £1,000.00 £385.00 Show arrow
V2542 Posterior excision of disc prolapse with undercutting facetectomy +/- decompression - lumbar region (1 or 2 levels) Xmajor £900.00 £330.00 Show arrow
V2543 Revision of posterior excision of disc prolapse with undercutting facetectomy (lumbar region) Complex £1,200.00 £385.00 Show arrow
V2560 Decompression for central spinal stenosis (one or two levels) Xmajor £900.00 £385.00 Show arrow
V2562 Decompression for central spinal stenosis (three or more levels) Complex £1,000.00 £440.00 Show arrow
A5410 Epidural blood patch Minor £150.00 £0.00 Show arrow
V3345 Mobilisation of the lumbar/thoracic vessels to provide spinal surgical access (by vascular surgeon) as sole procedure Major £650.00 £0.00 Show arrow
V3381 Prosthetic intervertebral disc replacement - lumbar region (3 or more levels) Complex £1,300.00 £990.00 Show arrow
V3341 Primary anterior discectomy, decompression and anterior fusion +/- instrumentation - lumbar region (3 or more levels) Xmajor £1,000.00 £495.00 Show arrow
V2501 Primary posterior fusion +/- decompression +/- discectomy - lumbar region (3 or more levels) Complex £1,000.00 £385.00 Show arrow
V2546 Posterior excision of disc prolapse with undercutting facetectomy +/- decompression - lumbar region (3 or more levels) Xmajor £900.00 £330.00 Show arrow
V2541 Posterior excision of disc prolapse (including microdiscectomy +/- decompression) - lumbar region (3 or more levels) Xmajor £900.00 £275.00 Show arrow
V2570 Percutaneous vertebroplasty Xmajor £1,000.00 £385.00 Show arrow
V2660 Revision of decompression for central spinal stenosis Complex £1,000.00 £440.00 Show arrow
V2500 Primary posterior fusion +/- decompression +/- discectomy - lumbar region (1 or 2 levels) Complex £1,000.00 £385.00 Show arrow
V3362 Primary posterior fusion with instrumentation +/- decompression +/- discectomy (including Graf stabilisation and all fusion approaches) (lumbar region) Complex £1,500.00 £495.00 Show arrow
V2652 Revision posterior fusion +/– instrumentation (lumbar region) Complex £1,500.00 £385.00 Show arrow
V3340 Primary anterior discectomy, decompression and anterior fusion +/- instrumentation - lumbar region (1 or 2 levels) Xmajor £1,000.00 £495.00 Show arrow
V3350 Combined anterior approach discectomy, decompression and fusion and posterior fusion (lumbar region) Complex £1,600.00 £550.00 Show arrow
V3380 Prosthetic intervertebral disc replacement - lumbar region (1 or 2 levels) Complex £1,300.00 £990.00 Show arrow
V4140 Removal of posterior spinal implant Major £450.00 £220.00 Show arrow
V4740 Image guided percutaneous spinal biopsy Major £550.00 £220.00 Show arrow
V4900 Open biopsy of lesion of spine where no other operative procedure on the spine is performed. Major £500.00 £220.00 Show arrow
V5210 Chemonucleosis (multiple levels) Intermediate £550.00 £165.00 Show arrow
W0660 Coccygectomy (multiple levels) Intermediate £400.00 £165.00 Show arrow
V5230 Discogram/diagnostic vertebral disc injection under X-ray control Minor £100.00 £100.00 Show arrow
V5002 Manipulation of spine under GA/IV sedation (sole procedure) Minor £100.00 £100.00 Show arrow
V5003 Manipulation of spine without GA/IV sedation (as sole procedure) Minor £50.00 £0.00 Show arrow
V2680 Revision anterior decompression with fusion and instrumentation (lumbar region) Complex £1,300.00 £495.00 Show arrow
Scoliosis (including kyphosis, fractures, tumours and infections)

V4100 Posterior correction of idiopathic juvenile scoliosis with instrumentation, +/- fusion (including spinal cord monitoring) Complex £2,500.00 £1,000.00 Show arrow
V4120 Anterior correction of idiopathic juvenile scoliosis with instrumentation, +/- fusion (including spinal cord monitoring) Complex £2,500.00 £1,000.00 Show arrow
V4000 Combined anterior and posterior correction and instrumentation, +/- fusion of idiopathic juvenile scoliosis (including spinal monitoring) Complex £2,500.00 £1,100.00 Show arrow
V4280 Correction of adult degenerative or adult scoliosis including decompression +/- fusion (including spinal cord monitoring) Complex £2,000.00 £900.00 Show arrow
V4010 Posterior correction of idiopathic juvenile kyphosis with instrumentation, +/- fusion (including spinal cord monitoring) Complex £2,500.00 £1,000.00 Show arrow
V4122 Anterior correction of idiopathic juvenile kyphosis with instrumentation, +/- fusion (including spinal cord monitoring) Complex £2,500.00 £1,000.00 Show arrow
V4160 Posterior correction of degenerative adult kyphosis with instrumentation, +/- fusion (including spinal cord monitoring) Complex £1,600.00 £550.00 Show arrow
V4150 Anterior correction of degenerative adult kyphosis with instrumentation, +/- fusion (including spinal cord monitoring) Complex £1,600.00 £550.00 Show arrow
V4300 Anterior vertebrectomy with decompression and implant Complex £2,500.00 £1,000.00 Show arrow
V4302 Combined anterior vertebrectomy with posterior fusion and instrumentation Complex £2,500.00 £1,100.00 Show arrow
V4142 Removal of posterior scoliosis instrumentation (as sole procedure) Major £450.00 £220.00 Show arrow
W2912 Application of halo (as sole procedure) Intermediate £200.00 £165.00 Show arrow
V4451 Balloon kyphoplasty – single level Major £600.00 £220.00 Show arrow
V4452 Balloon kyphoplasty - two level Xmajor £750.00 £275.00 Show arrow
V4453 Balloon kyphoplasty - greater than two levels Xmajor £900.00 £275.00 Show arrow
V4081 Anterolateral access with instrumentation +/- decompression +/- duscectomy (including graf stabilisation and all fusion approaches) -lumbar region (3 or more levels) Complex £1,500.00 £495.00 Show arrow
V4081 Anterolateral access with instrumentation +/- decompression +/- duscectomy (including graf stabilisation and all fusion approaches) -lumbar region (3 or more levels) Complex £1,500.00 £495.00 Show arrow
V4080 Anterolateral access with instrumentation +/- decompression +/- discectomy (including graf stabilisation & all fusion approaches) lumbar region (1 or 2 levels) Complex £1,500.00 £495.00 Show arrow
V3300 Percutaneous intradiscal laser ablation (lumbar region) Major £700.00 £250.00