CPT 28297 · Spinal Fusion · Medicare (WPS MAC)
Bunionectomy with First Metatarsal-Cuneiform Joint Arthrodesis (Lapidus) at Medicare (WPS MAC).
How Medicare (WPS MAC) approaches CPT 28297 (Bunionectomy with First Metatarsal-Cuneiform Joint Arthrodesis (Lapidus)) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-02
Criteria summary
High-level themes from the Medicare (WPS MAC) policy of record for CPT 28297. 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.
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