CPT 62330 · Decompression
MILD — Percutaneous Lumbar Decompression (no image guidance)
Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, single/multiple levels, lumbar; without imaging guidance. (Effective 01/01/2026; replaces 0275T in part.)
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Rubrica tracks payor coverage for CPT 62330 (MILD — Percutaneous Lumbar Decompression (no image guidance)) across 116 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.
Top payors covering CPT 62330
Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.
| Payor | Coverage | Prior auth |
|---|---|---|
| Aetna | Covered | No PA |
| Aetna Better Health Medicaid | Covered | Prior auth |
| Aetna Better Health of Florida | Covered | No PA |
| Aetna Better Health of Maryland | Covered | No PA |
| Aetna Better Health of New Jersey | Covered | No PA |
| Aetna Medicare Advantage | Covered | Prior auth |
| Alabama Medicaid | Covered | Prior auth |
| Alabama Medicaid (FFS) | Covered | Prior auth |
| Allstate Auto / PIP | Covered | Prior auth |
| AmTrust Financial WC | Covered | Prior auth |
| Ambetter | Covered | No PA |
| AmeriHealth Caritas | Covered | No PA |
Coverage themes for CPT 62330
Common patterns across the 116 payors we track. Specific criteria per payor are available after sign-in.
Most payors require ≥12 weeks of conservative care before approving 62330.
41 of 116 payors require imaging concordance documentation.
Of the 116 payors with coverage records for CPT 62330, 70 require prior authorization, 0 cover without prior authorization, and 38 flag the procedure as investigational or experimental under current criteria.
See the policy for every payor.
Sign in to see verbatim coverage criteria, conservative-care duration requirements, imaging concordance rules, and the documentation each payor wants in the submission.
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