27889 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 27889

1 of 1 payer prior-auth lists that name 27889 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue).

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)

Payer coverage policies that name 27889

27889 appears in 6 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 27600-27899)Jul 30, 2026payer document
AetnaComplex Regional Pain Syndrome (CRPS): Treatments (0447)not coveredJul 16, 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
AetnaNerve Blocks (0863)listed, no stanceJul 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

Medicaid fee-for-service

  • AZ: $3026.13 (asc), effective Oct 1, 2026
  • CO: $499.41 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $464.73 (physician, non-facility), effective Jan 1, 2026
  • IL: $447.78 (practitioner), effective Apr 1, 2024
  • IN: $483.90 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $268.89 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $3607.39 (asc), effective Jan 1, 2026
  • LA: $217.00 (asc), effective Jul 1, 2012
  • MA: $2382.86 (asc), effective May 1, 2026
  • MS: $2808.67 (comprehensive, facility), effective Oct 1, 2025
  • ND: $2126.56 (physician, facility), effective Aug 1, 2026
  • NE: $785.00 (asc), effective Jul 1, 2024
  • NY: $335.18 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $505.91 (physician), effective Jan 1, 2000
  • OK: $3291.10 (asc), effective Jan 1, 2026
  • TX: $2398.52 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $517.65 (medical), effective Jul 1, 2026
  • VT: $5634.17 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $366.60 (asc), effective Jul 1, 2026
  • WY: $3208.96 (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.