CPT 63047 · Spine Surgery · Pennsylvania Medical Assistance
Laminectomy + Facetectomy + Foraminotomy — Lumbar at Pennsylvania Medical Assistance.
How Pennsylvania Medical Assistance approaches CPT 63047 (Laminectomy + Facetectomy + Foraminotomy — Lumbar) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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PAMed-Surg-2026Criteria summary
High-level themes from the Pennsylvania Medical Assistance policy of record for CPT 63047. 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.
Source: PA Medical Assistance Bulletin — Surgical Procedures
See the full Pennsylvania Medical Assistance criteria.
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