CPT 27279 · SI Fusion · Medicare (FCSO MAC)
SI Fusion — Minimally Invasive at Medicare (FCSO MAC).
How Medicare (FCSO MAC) approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2026-05-03, the policy covers this code without prior authorization.
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Coverage
Covered
Prior auth
No prior auth
Last reviewed
2026-05-03
Criteria summary
High-level themes from the Medicare (FCSO MAC) policy of record for CPT 27279. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 24 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Diagnostic SI joint injection(s) documentation required (typically with ≥75% relief).
See the full Medicare (FCSO MAC) criteria.
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