CPT 27279 · SI Fusion · Priority Partners MCO
SI Fusion — Minimally Invasive at Priority Partners MCO.
How Priority Partners MCO approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2026-04-27, the policy covers this code with prior authorization required.
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eviCore Spine Surgery (SIJ fusion)Criteria summary
High-level themes from the Priority Partners MCO 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 Two diagnostic SIJ injections (intra-articular) with concordant relief documentation required (typically with ≥75% relief).
Source: JHHC / eviCore Spine Surgery — Sacroiliac Joint Fusion (Priority Partners)
See the full Priority Partners MCO criteria.
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