45000 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 45000

Payer coverage policies that name 45000

45000 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaUrological Supplies (0533)listed, no stance (range 45000-45999)Jul 30, 2026payer document

Medicaid fee-for-service

  • AZ: $383.41 (asc), effective Oct 1, 2026
  • CO: $342.61 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $430.73 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025
  • IL: $295.99 (practitioner), effective Apr 1, 2024
  • IN: $329.74 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $210.00 (asc, facility), effective Aug 1, 1982
  • KY: $641.09 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $431.31 (asc), effective May 1, 2026
  • MS: $506.37 (comprehensive, facility), effective Oct 1, 2025
  • ND: $377.92 (physician, facility), effective Aug 1, 2026
  • NE: $637.00 (asc), effective Jul 1, 2024
  • NY: $184.06 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $220.44 (physician), effective Jan 1, 2024
  • OK: $584.88 (asc), effective Jan 1, 2026
  • TX: $429.26 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $357.64 (medical), effective Jul 1, 2026
  • VT: $929.15 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $529.20 (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.