CPT 22633 · Other Procedure · Medicare (FCSO MAC)
Arthrodesis, Combined Posterior + Posterior Interbody — Lumbar at Medicare (FCSO MAC).
How Medicare (FCSO MAC) approaches CPT 22633 (Arthrodesis, Combined Posterior + Posterior Interbody — Lumbar) for prior-authorization review: at last review on 2026-04-15, the policy covers this code without prior authorization.
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L33382Criteria summary
High-level themes from the Medicare (FCSO MAC) policy of record for CPT 22633. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: LCD - Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions (L33382)
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