FL: $488.11 (physician, non-facility), effective Jan 1, 2026
IL: $442.90 (practitioner), effective Jul 1, 2026
IN: $492.06 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
KY: $1605.64 (asc), effective Jan 1, 2026
LA: $217.00 (asc), effective Jul 1, 2012
MA: $1093.32 (asc), effective May 1, 2026
MS: $1263.33 (comprehensive, facility), effective Oct 1, 2025
ND: $946.52 (physician, facility), effective Aug 1, 2026
NE: $637.00 (asc), effective Jul 1, 2024
OH: $367.97 (physician), effective Jan 1, 2024
OK: $1464.86 (asc), effective Jan 1, 2026
TX: $1088.27 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
VA: $543.69 (medical), effective Jul 1, 2026
VT: $2540.58 (outpatient_hospital_opps), effective Feb 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.