CPT 27280 · SI Fusion · Maryland Physicians Care
SI Fusion — Open at Maryland Physicians Care.
How Maryland Physicians Care approaches CPT 27280 (SI Fusion — Open) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-06
Policy number
NIA MSK / IPM Guidelines (2024)Criteria summary
High-level themes from the Maryland Physicians Care policy of record for CPT 27280. 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) under image guidance documentation required (typically with ≥75% relief).
Source: MPC / Evolent (NIA) MSK Guidelines — Sacroiliac Joint Fusion
See the full Maryland Physicians Care criteria.
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