M53.3: Sacrococcygeal disorders, not elsewhere classified
M53.3, sacrococcygeal disorders, not elsewhere classified, is listed as a covered diagnosis in 9 Medicare billing and coding articles that apply to 15 HCPCS Level II codes, including G0260 (Injection procedure for sacroiliac joint; provision of…), G0283 (Electrical stimulation (unattended), to one or more areas…), E0783 (Infusion pump system, implantable, programmable (includes…). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M53.3 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | Special coverage instructions apply | — | 5 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| E0783 | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $9,917.33–$11,667.45 (NU) | 1 |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | Special coverage instructions apply | $10,969.75–$11,380.88 (NU) | 1 |
| E0782 | Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $5,200.92–$6,118.73 (NU) | 1 |
| E0785 | Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement | Special coverage instructions apply | $572.38–$673.39 (KF) | 1 |
| J7999 | Compounded drug, not otherwise classified | Special coverage instructions apply | — | 1 |
| J2278 | Injection, ziconotide, 1 microgram | Special coverage instructions apply | — | 1 |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg | Special coverage instructions apply | — | 1 |
| A4220 | Refill kit for implantable infusion pump | Special coverage instructions apply | — | 1 |
| J9200 | Injection, floxuridine, 500 mg | Special coverage instructions apply | — | 1 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| G0282 | Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281 | Non-covered by Medicare | Not covered | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 1 |
Medicare policy articles listing M53.3
- A59154: Billing and Coding: Sacroiliac Joint Injections and Procedures (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L39383, L39402, L39455, L39462
- A59192: Billing and Coding: Sacroiliac Joint Injections and Procedures (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L39383, L39402, L39455, L39462
- A59233: Billing and Coding: Sacroiliac Joint Injections and Procedures (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L39383, L39402, L39455, L39462
- A59244: Billing and Coding: Sacroiliac Joint Injections and Procedures (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L39383, L39402, L39455, L39462
- A59257: Billing and Coding: Sacroiliac Joint Injections and Procedures (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L39383, L39402, L39455, L39462
- A56034: Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L35456
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M53 diagnoses (Other and unspecified dorsopathies, not elsewhere classified)
- M53.0 — Cervicocranial syndrome
- M53.1 — Cervicobrachial syndrome
- M53.2X7 — Spinal instabilities, lumbosacral region
- M53.2X8 — Spinal instabilities, sacral and sacrococcygeal region
- M53.82 — Other specified dorsopathies, cervical region
- M53.85 — Other specified dorsopathies, thoracolumbar region
- M53.86 — Other specified dorsopathies, lumbar region
- M53.87 — Other specified dorsopathies, lumbosacral region
- M53.88 — Other specified dorsopathies, sacral and sacrococcygeal region
Frequently asked questions
Does Medicare cover M53.3 (Sacrococcygeal disorders, not elsewhere classified)?
Medicare covers items and services, not diagnoses. 9 Medicare billing and coding articles list M53.3 as a covered diagnosis for 15 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M53.3?
The Level II codes from the policies most specific to this diagnosis are G0260 (Injection procedure for sacroiliac joint; provision of…, 5 articles); G0283 (Electrical stimulation (unattended), to one or more areas…, 1 article); E0783 (Infusion pump system, implantable, programmable (includes…, 1 article); E0786 (Implantable programmable infusion pump, replacement…, 1 article); E0782 (Infusion pump, implantable, non-programmable (includes all…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with M53.3?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list M53.3?
A59154 (Billing and Coding: Sacroiliac Joint Injections and Procedures); A59192 (Billing and Coding: Sacroiliac Joint Injections and Procedures); A59233 (Billing and Coding: Sacroiliac Joint Injections and Procedures), and 6 more articles.
What is ICD-10-CM code M53.3?
M53.3 is the ICD-10-CM code for sacrococcygeal disorders, not elsewhere classified, in category M53 (Other and unspecified dorsopathies, not elsewhere classified), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0260
- Watch G0260 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0260
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup