CPT 63055 · Spinal Decompression · Medicare (Palmetto GBA MAC)
Transpedicular Decompression — Thoracic at Medicare (Palmetto GBA MAC).
How Medicare (Palmetto GBA 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.
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Criteria summary
High-level themes from the Medicare (Palmetto GBA 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 (Palmetto GBA MAC) LCD / Local Coverage Article
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