Rubrica

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.)

Free with practitioner sign-in — magic-link email auth, no credit card.

116
Payors tracked
66
Cover this CPT (57%)
70
Require prior auth (60%)
38
Flag investigational

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.

PayorCoveragePrior auth
AetnaCoveredNo PA
Aetna Better Health MedicaidCoveredPrior auth
Aetna Better Health of FloridaCoveredNo PA
Aetna Better Health of MarylandCoveredNo PA
Aetna Better Health of New JerseyCoveredNo PA
Aetna Medicare AdvantageCoveredPrior auth
Alabama MedicaidCoveredPrior auth
Alabama Medicaid (FFS)CoveredPrior auth
Allstate Auto / PIPCoveredPrior auth
AmTrust Financial WCCoveredPrior auth
AmbetterCoveredNo PA
AmeriHealth CaritasCoveredNo 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.

Sign in — free for practitioners →