I recently replaced the stock 245/70R18 temporary use spare tire with a LT275/70R18 tire with no modifications. The LT275/70R18 tire clears without touching the heat shield, hitch, and track bar; and is mounted on the stock 18" spare wheel. I am posting this thread because I found at least two posts on this site that says this tire doesn't fit, but it does. I run Wildpeak A/T4W 305/55R20 (33x12.5x20) tires, and the LT275/70R18 spare tire is the same diameter at 33.2". My truck is a 2022 Big Horn with 5', 7" box. I hope I never have to use this spare tire, but it's good piece of mind and it cost less than $200 installed.