CPT 63075 · Decompression — Surgical
Discectomy, Anterior — Cervical
Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace. Do not report with 22551 at same level.
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Rubrica tracks payor coverage for CPT 63075 (Discectomy, Anterior — Cervical) across 40 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 63075
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 | Prior auth |
| Aetna Medicare Advantage | Covered | Prior auth |
| Ambetter | Covered | Prior auth |
| Anthem BCBS | Covered | Prior auth |
| BCBS Alabama | Covered | Prior auth |
| BCBS Federal Employee Program | Covered | Prior auth |
| BCBS Massachusetts | Covered | Prior auth |
| BCBS Michigan | Covered | Prior auth |
| BCBS Montana | Covered | Prior auth |
| BCBS New Mexico | Covered | Prior auth |
| BCBS Oklahoma | Covered | Prior auth |
| BCBS Tennessee | Covered | Prior auth |
Coverage themes for CPT 63075
Common patterns across the 40 payors we track. Specific criteria per payor are available after sign-in.
Most payors require ≥12 weeks of conservative care before approving 63075.
37 of 40 payors require imaging concordance documentation.
Of the 40 payors with coverage records for CPT 63075, 29 require prior authorization, 11 cover without prior authorization, and 0 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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