27488 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 27488

7 of 7 payer prior-auth lists that name 27488 require prior authorization or set conditions: Aetna, Blue Cross and Blue Shield of Texas, Blue Shield of California, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of CaliforniaBlue Shield commercialCAprior auth requiredSep 1, 2026Prior Authorization List for Blue Shield
AetnaCommercialAllprior auth requiredNot required for Student Health or Allina Health | Aetna plansOct 1, 2026Participating provider precertification list for Aetna®
AetnaMedicare AdvantageAllprior auth requiredNot required for Student Health or Allina Health | Aetna plansOct 1, 2026Participating provider precertification list for Aetna®
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)
UnitedHealthcare Community PlanMassachusetts OneCareMAprior auth requiredNov 1, 2025Prior authorization requirements for Massachusetts OneCare Effective November 1, 2025
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO)MAprior auth requiredNov 1, 2025CPT® is a registered trademark of the American Medical Association. Prior authorization requirements for Massachusetts Senior Care Options Effective November 1, 2025
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO) and OneCareMAprior auth requiredOct 1, 2026Prior authorization requirements for Massachusetts MA SCO OneCare Effective October 1, 2026

Payer coverage policies that name 27488

27488 appears in 7 coverage policies from Aetna, Regence.

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
AetnaKnee Arthroplasty (0660)covered if criteria are metOct 8, 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
RegenceKnee Surgeries (Surgery 229)listed, no stanceJan 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in WA.

  • AZ: $8052.74 (asc), effective Oct 1, 2026
  • CO: $957.85 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $855.43 (physician, non-facility), effective Jan 1, 2026
  • IL: $831.24 (practitioner), effective Apr 1, 2024
  • IN: $920.12 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $300.00 (asc, facility), effective Aug 1, 1982
  • KY: $921.03 (physician, facility), effective Jan 1, 2026
  • LA: $972.20 (professional), effective Jul 1, 2025
  • MA: $898.23 (physician_surgery), effective May 1, 2024
  • MS: $910.69 (comprehensive), effective Jul 1, 2026
  • ND: $5463.22 (physician, facility), effective Aug 1, 2026
  • NE: $926.24 (physician, non-facility), effective Jul 1, 2026
  • NY: $578.24 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $905.32 (physician), effective Jan 1, 2024
  • OK: $963.89 (physician, non-facility), effective Jul 1, 2026
  • TX: $143.62 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2026
  • VA: $952.84 (medical), effective Jul 1, 2026
  • VT: $9968.74 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $645.92 (physician, facility), effective Jul 1, 2026
  • WY: $5677.74 (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.