27358 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 27358

5 of 5 payer prior-auth lists that name 27358 require prior authorization or set conditions: Cigna, HealthSpring.

PayerPlanStatePrior authConditionsSinceSource
CignaACA/IFPAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2016Master Precertification List (For Health Care Providers)
CignaComplete/PHS+/PreferredAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2016Master Precertification List (For Health Care Providers)
CignaMusculoskeletalAllprior auth under conditionsAdd-on code: requested with the primary procedureMar 7, 2026Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs
CignaMusculoskeletalAllprior auth under conditionsAdd-on code: requested with the primary procedureMar 7, 2026Cigna Commercial Prior Authorization Procedure Code List: Musculoskeletal - Joint Surgery
HealthSpringMedicare AdvantageAllprior auth requiredJan 1, 20252026 Q4 Prior Authorization List

Payer coverage policies that name 27358

27358 appears in 5 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBone and Tendon Graft Substitutes and Adjuncts (0411)listed, no stance (range 27301-27499)Aug 18, 2026payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)not covered (range 27301-27599)Jun 19, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 27301-27599)Jul 23, 2026payer document
AetnaRemote Ischemic Conditioning (0814)listed, no stance (range 20000-29999)Nov 20, 2025payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 20100-29999)Jul 29, 2026payer document

Recent prior-auth changes

  • Jul 1, 2026: PA added, HealthSpring

Medicaid fee-for-service

  • AZ: $2224.42 (outpatient_hospital), effective Oct 1, 2013
  • CO: $221.01 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $188.43 (physician, non-facility), effective Jan 1, 2026
  • IL: $272.06 (practitioner), effective Apr 1, 2024
  • IN: $206.36 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $170.56 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $233.58 (asc), effective Jul 1, 2012
  • MA: $0.00 (asc), effective May 1, 2026
  • MS: $198.85 (comprehensive), effective Jul 1, 2026
  • ND: $243.69 (physician), effective Aug 1, 2026
  • NE: $891.00 (asc), effective Jul 1, 2024
  • NY: $141.78 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $245.46 (physician), effective Jan 1, 2000
  • OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $32.26 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2026
  • VA: $204.86 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $136.06 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.