CPT 64495 · Facet/MBB · Medicare (Noridian JF MAC)
Facet/MBB — Lumbar/Sacral (3rd+ level) at Medicare (Noridian JF MAC).
How Medicare (Noridian JF MAC) approaches CPT 64495 (Facet/MBB — Lumbar/Sacral (3rd+ level)) for prior-authorization review: at last review on 2026-05-09, the policy does not cover this code without prior authorization.
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L38803Criteria summary
High-level themes from the Medicare (Noridian JF MAC) policy of record for CPT 64495. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: LCD L38803 (Noridian_JF)
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