CPT 63055 · Spinal Decompression · Medicare (Noridian JF MAC)
Transpedicular Decompression — Thoracic at Medicare (Noridian JF MAC).
How Medicare (Noridian JF MAC) approaches CPT 63055 (Transpedicular Decompression — Thoracic) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
Criteria summary
High-level themes from the Medicare (Noridian JF MAC) policy of record for CPT 63055. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Medicare (Noridian JF MAC) LCD / Local Coverage Article
See the full Medicare (Noridian JF MAC) criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →