45330 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 45330

Payer coverage policies that name 45330

45330 appears in 9 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Centene, Premera Blue Cross, Regence, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaColonoscopy, Colorectal Cancer Screening, and Related Procedures (0516)covered if criteria are met (range 45330-45350)Aug 20, 2026payer document
AetnaRisankizumab-rzaa (Skyrizi) (1009)listed, no stance (range 45300-45393)Jul 1, 2026payer document
AetnaUrological Supplies (0533)listed, no stance (range 45000-45999)Jul 30, 2026payer document
Blue Cross & Blue Shield of MississippiColonoscopy Flexible Sigmoidoscopy And Ct Colonography (L.2.04.403)covered if criteria are metpayer document
CenteneAmbulatory Surgery Center Optimization Reference Number: CP.MP.158 (CP.MP.158)covered if criteria are metJun 1, 2022payer document
CenteneAnesthesiology Services for Gastrointestinal Endoscopy (CP.MP.161)covered if criteria are metMay 1, 2019payer document
Premera Blue CrossPreventive Care
(Visualizes the rectum, sigmoid | CT colonography are positive, follow-up
listed, no stanceSep 21, 2026payer document
RegenceSurgical Site of Care – Colonoscopy and Sigmoidoscopy (Utilization Management 20)listed, no stanceFeb 1, 2026payer document
UnitedHealthcarePreventive Care Services (MP.016.59)
Preventive Benefit Instructions to the | benefits to apply.
listed, no stanceJul 1, 2026payer document

Medicaid fee-for-service

  • AZ: $101.20 (asc), effective Oct 1, 2026
  • CO: $46.78 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $41.82 (physician, facility), effective Jan 1, 2026
  • IL: $54.73 (practitioner), effective Apr 1, 2024
  • IN: $43.59 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $225.00 (asc, facility), effective Aug 1, 1982
  • KY: $180.55 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $123.62 (asc), effective May 1, 2026
  • MS: $119.03 (comprehensive, facility), effective Oct 1, 2025
  • ND: $178.58 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $29.69 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $52.42 (physician, facility), effective Jan 1, 2024
  • OK: $164.72 (asc), effective Jan 1, 2026
  • TX: $130.67 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $46.59 (medical, facility), effective Jul 1, 2026
  • VT: $722.08 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $31.91 (physician, facility), effective Jul 1, 2026
  • WY: $411.26 (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.