43889 CPT® code: payer coverage and prior authorization20 of 20 payer prior-auth lists that name 43889 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), CarePlus Health Plans, Cigna, HealthSpring, Humana.
43889 appears in 21 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Obesity Surgery (0157) Sleeve gastrectomy with SIPS, Laparoscopic single-anastomosis duodeno-ileal bypass with gastric plication | not covered | Jul 21, 2026 | payer document |
| Anthem | Bariatric Surgery and Other Treatments for Clinically Severe Obesity (CG-SURG-83) | covered if criteria are met | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Morbid Obesity (L.7.01.431) | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | Medical and Surgical Management of Obesity and Anorexiants (379) | unproven / investigational | payer document | |
| Blue Cross NC | Bariatric Surgery | listed, no stance | Apr 1, 2026 | payer document |
| Cigna | Bariatric Surgery and Procedures (0051) | covered if criteria are met | Jul 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Bariatric Surgery (SUR716.003) CPT Codes 00797, 43281, 43290, 43291, 43332, 43333, 43334, 43335, 43336, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Bariatric Surgery (7.01.516) Page | 11 of 63 | ∞ | listed, no stance | Jul 27, 2026 | payer document |
| Regence | Bariatric Surgery (Surgery 58) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Bariatric Surgery (2026T0362RR) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (CS007.X) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for Kansas Only) (CS007KS.02) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for Kentucky Only) (CS007KY.12) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for Nebraska Only) (CS007NE.V) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for New Jersey Only) (CS007NJ.Q) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for New Mexico Only) (CS007NM.C) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for North Carolina Only) (CSNCT0362.06) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for Ohio Only) (CS007OH.E) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for Pennsylvania Only) (CS007PA.S) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Bariatric Surgery (for Tennessee Only) (CS007TN.S) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Surgical Procedures (MMP108.10) Bariatric Surgery | listed, no stance | Sep 1, 2026 | payer document |
Prior authorization required or conditional in CO, IN, LA, ND.
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.