17283 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 17283

Payer coverage policies that name 17283

17283 appears in 5 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaCarbon Dioxide Laser (0427)covered if criteria are met (range 17260-17286)Jul 8, 2026payer document
AetnaCryoablation (0100)listed, no stance (range 17000-17286)Aug 4, 2026payer document
AetnaDermabrasion, Chemical Peels, and Acne Surgery (0251)listed, no stance (range 17260-17286)Apr 15, 2026payer document
AetnaPulsed Dye Laser Treatment (0559)covered if criteria are metSep 18, 2026payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 10040-19499)Jul 29, 2026payer document

Medicaid fee-for-service

  • AZ: $77.69 (asc), effective Oct 1, 2026
  • CO: $198.35 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $118.12 (physician, facility), effective Jan 1, 2026
  • IL: $164.50 (practitioner), effective Apr 1, 2024
  • IN: $132.70 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $300.00 (asc, facility), effective Aug 1, 1982
  • KY: $138.60 (asc), effective Jan 1, 2026
  • LA: $192.60 (professional), effective Jul 1, 2025
  • MA: $122.09 (asc), effective May 1, 2026
  • MS: $112.57 (comprehensive, facility), effective Oct 1, 2025
  • ND: $137.09 (physician, facility), effective Aug 1, 2026
  • NE: $156.22 (physician, facility), effective Jul 1, 2026
  • OH: $114.94 (physician, facility), effective Jan 1, 2024
  • OK: $125.71 (physician, facility), effective Jul 1, 2026
  • TX: $117.10 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $122.11 (medical, facility), effective Jul 1, 2026
  • VT: $315.64 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $83.51 (physician, facility), effective Jul 1, 2026
  • WY: $179.77 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.