33477 CPT® code: payer coverage and prior authorization62 of 63 payer prior-auth lists that name 33477 require prior authorization or set conditions: Cigna, HealthSpring, Molina Complete Care (Virginia), Molina Healthcare of California, Molina Healthcare of Idaho, Molina Healthcare of Illinois, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Mississippi, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of Texas, Molina Healthcare of Utah, Neighborhood Health Partnership, Oxford Health Plans, Passport by Molina Healthcare (Kentucky), Rocky Mountain Health Plans, Surest, UnitedHealthcare, and others.
33477 appears in 35 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Anesthetic and Antiemetic Infusion Pumps (0607) | listed, no stance (range 33016-37799) | Sep 9, 2026 | payer document |
| Aetna | Bupivacaine Liposome (Exparel) (0941) | listed, no stance (range 33010-37799) | Jul 30, 2026 | payer document |
| Aetna | Cardiovascular Ultrafiltration (0741) | listed, no stance (range 33010-37790) | Oct 30, 2025 | payer document |
| Aetna | Cryoanalgesia and Therapeutic Cold (0297) | listed, no stance (range 33016-33999) | Apr 14, 2026 | payer document |
| Aetna | Functional Electrical Stimulation and Neuromuscular Electrical Stimulation (0677) | listed, no stance (range 33016-33999) | Sep 10, 2026 | payer document |
| Aetna | Inpatient Admission Prior to Surgery (Preop Days) (0255) | listed, no stance (range 33016-33980) | May 13, 2026 | payer document |
| Aetna | Intravenous Iron Therapy (0575) | listed, no stance (range 33016-33999) | Jul 1, 2026 | payer document |
| Aetna | Negative Pressure Wound Therapy (0334) | listed, no stance (range 33016-37799) | Jun 8, 2026 | payer document |
| Aetna | Nerve Blocks (0863) | listed, no stance (range 33016-33999) | Jul 23, 2026 | payer document |
| Aetna | Nitric Oxide, Inhalational (INO) (0518) | not covered (range 33016-37790) | Jul 2, 2026 | payer document |
| Aetna | Procalcitonin (PCT) (0771) | listed, no stance (range 33016-33997) | Nov 13, 2025 | payer document |
| Aetna | Stereolithographic Models and Implants (0613) | listed, no stance (range 33010-37790) | Sep 3, 2026 | payer document |
| Aetna | Transcatheter Pulmonary Valve Implantation (0821) | covered if criteria are met | Apr 22, 2026 | payer document |
| Anthem | Transcatheter Mitral, Pulmonary, and Tricuspid Heart Valve Procedures (SURG.00121) | covered if criteria are met | Feb 19, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Transcatheter Pulmonary Valve Implantation (A.7.01.131) | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | Transcatheter Pulmonary Valva Implantation (403) | listed, no stance | payer document | |
| Blue Shield of California | Transcatheter Pulmonary Valve Implantation (7.01.131) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Transcatheter Pulmonary Valve Implantation (CAM 701131) | listed, no stance | Jan 1, 2026 | payer document |
| Cigna | Transcatheter Heart Valve Procedures (0501) | covered if criteria are met | Dec 15, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Transcatheter Pulmonary Valve Implantation (SUR707.029) | listed, no stance | Oct 1, 2026 | payer document |
| Premera Blue Cross | Transcatheter Pulmonary Valve Implantation (7.01.131) | listed, no stance | Aug 10, 2026 | payer document |
| UnitedHealthcare | Cardiovascular Diagnostic and Therapeutic Procedures (MMP013.22) Transcatheter Pulmonary Heart Valve Replacement | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (CS123.X) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (2026T0557FF) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Idaho Only) (CS123ID.C) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Indiana Only) (CS123IN.12) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Kansas Only) (CS123KS.03) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Kentucky Only) (CS123KY.14) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Nebraska Only) (CS123NE.V) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for New Jersey Only) (CS123NJ.S) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for New Mexico Only) (CS123NM.D) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for North Carolina Only) (CSNCT0557.06) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Ohio Only) (CS123OH.F) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Pennsylvania Only) (CS123PA.X) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Transcatheter Procedures for Heart Valve Conditions (for Tennessee Only) (CS123TN.W) | listed, no stance | Aug 1, 2026 | payer document |
Prior authorization required or conditional in IN, WA.
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.