Implanted Electrical Stimulator fo… | UMR (UnitedHealthcare)

Implanted Electrical Stimulator for the Spinal Cord

UMR (UnitedHealthcare) · PayerPolicy · UMR-POL-UMR-implanted-electrical-stimulator-spinal-cord

Status: Active
Effective: January 1, 2026
Last reviewed by UMR (UnitedHealthcare): January 1, 2026
Last checked by Backwork: October 1, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with UMR (UnitedHealthcare) before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
63650	CPT	Covered
63655	CPT	Covered
63685	CPT	Covered
63688	CPT	Covered
L8679	HCPCS	Covered
L8680	HCPCS	Covered
L8682	HCPCS	Covered
L8685	HCPCS	Covered
L8686	HCPCS	Covered
L8687	HCPCS	Covered
L8688	HCPCS	Covered
L8695	HCPCS	Covered