Payer policies › CPT 4233542335 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 42335 1 of 1 payer prior-auth lists that name 42335 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue).
Payer coverage policies that name 42335 42335 appears in 2 coverage policies from Aetna, Regence.
Payer Policy Role in policy Reviewed Document Aetna Sialolithiasis (Salivary Stones) (0716) listed, no stance (range 42330-42340) Oct 14, 2025 payer document Regence Surgical Site of Care – Hospital Outpatient (Utilization Management 19) listed, no stance May 1, 2026 payer document
Recent prior-auth changes Oct 1, 2026: PA removed, UnitedHealthcare Community Plan Medicaid fee-for-service AZ: $165.85 (asc), effective Oct 1, 2026 CO: $249.12 (chp_plus, non-facility), effective Jul 1, 2026 FL: $186.26 (physician, facility), effective Jan 1, 2026 IL: $240.00 (practitioner), effective Jul 1, 2026 IN: $205.37 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $312.27 (asc, facility), effective Aug 1, 1982 KY: $295.88 (asc), effective Jan 1, 2026 LA: $339.15 (professional), effective Jul 1, 2025 MA: $235.59 (asc), effective May 1, 2026 MS: $232.90 (comprehensive, facility), effective Oct 1, 2025 ND: $292.66 (physician, facility), effective Aug 1, 2026 NE: $153.85 (physician, facility), effective Jul 1, 2026 NY: $125.17 (physician_surgery, facility), effective Jul 1, 2026 OH: $167.07 (physician, facility), effective Jan 1, 2024 OK: $209.61 (physician, facility), effective Jul 1, 2026 TX: $252.76 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $207.47 (medical, facility), effective Jul 1, 2026 VT: $2574.33 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $143.13 (physician, facility), effective Jul 1, 2026 WY: $1466.22 (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.