27656 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 27656

3 of 3 payer prior-auth lists that name 27656 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Molina Healthcare of Iowa, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross Blue Shield of Arizona (AZ Blue)Federal Employee Program (FEP)AZprior auth under conditionsFEP Blue Focus onlySep 1, 2026Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026)
Molina Healthcare of IowaMedicaidIAprior auth requiredJul 1, 2023IA Prior Authorization Matrix, effective Q3 2023
UnitedHealthcare Community PlanMaryland HealthChoiceMDprior auth under conditionsonly with dx F64.0, F64.1, F64.2, F64.8, F64.9, Z87.890Sep 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026

Payer coverage policies that name 27656

27656 appears in 5 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 27600-27899)Jul 30, 2026payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)not covered (range 27600-27899)Jun 19, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 27600-27899)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 27650-27692)Jul 29, 2026payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 20100-29999)Jul 29, 2026payer document

Medicaid fee-for-service

  • AZ: $1062.88 (asc), effective Oct 1, 2026
  • CO: $224.49 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $249.64 (physician, facility), effective Jan 1, 2026
  • IL: $299.70 (podiatrist), effective Oct 1, 2014
  • IN: $265.89 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $450.00 (asc, facility), effective Aug 1, 1982
  • KY: $1605.64 (asc), effective Jan 1, 2026
  • LA: $182.30 (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: $552.00 (asc), effective Jul 1, 2024
  • NY: $168.66 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $180.99 (physician, facility), effective Jan 1, 2024
  • OK: $1464.86 (asc), effective Jan 1, 2026
  • TX: $1605.18 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $278.07 (medical, facility), effective Jul 1, 2026
  • VT: $2540.58 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1447.00 (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.