Payer policies › CPT 2357523575 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 23575 Payer coverage policies that name 23575 23575 appears in 7 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Bupivacaine Liposome (Exparel) (0941) listed, no stance (range 23570-23630) Jul 30, 2026 payer document Aetna Continuous Passive Motion (CPM) Machines (0010) listed, no stance (range 23000-23921) Mar 5, 2026 payer document Aetna Infusion Pumps (0161) listed, no stance (range 23000-23921) Mar 31, 2026 payer document Aetna Intraoperative Neurophysiological Monitoring (0697) not covered (range 23000-23929) Jun 19, 2026 payer document Aetna Nerve Blocks (0863) listed, no stance (range 23000-23929) Jul 23, 2026 payer document Aetna Remote Ischemic Conditioning (0814) listed, no stance (range 20000-29999) Nov 20, 2025 payer document Aetna Skin and Soft Tissue Substitutes (0244) not covered (range 20100-29999) Jul 29, 2026 payer document
Medicaid fee-for-service AZ: $504.49 (asc), effective Oct 1, 2026 CO: $313.60 (chp_plus, non-facility), effective Jul 1, 2026 FL: $294.84 (physician, facility), effective Jan 1, 2026 IL: $265.08 (practitioner), effective Apr 1, 2024 IN: $301.67 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $100.00 (asc, facility), effective Aug 1, 1982 KY: $852.05 (asc), effective Jan 1, 2026 LA: $182.30 (asc), effective Jul 1, 2012 MA: $606.05 (asc), effective May 1, 2026 MS: $670.63 (comprehensive, facility), effective Oct 1, 2025 ND: $502.29 (physician, facility), effective Aug 1, 2026 NE: $413.00 (asc), effective Jul 1, 2024 NY: $168.95 (physician_surgery, facility), effective Jul 1, 2026 OH: $197.60 (physician, facility), effective Jan 1, 2024 OK: $777.34 (asc), effective Jan 1, 2026 TX: $593.04 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $328.41 (medical, facility), effective Jul 1, 2026 VT: $1248.54 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $308.28 (asc), effective Jul 1, 2026 WY: $711.11 (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.