47535 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 47535

Payer coverage policies that name 47535

47535 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaPancreaticoduodenectomy (Whipple Resection) (0365)listed, no stanceMay 22, 2026payer document
AetnaProcalcitonin (PCT) (0771)listed, no stance (range 47533-47537)Nov 13, 2025payer document

Medicaid fee-for-service

  • AZ: $1221.04 (asc), effective Oct 1, 2026
  • CO: $151.70 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $131.90 (physician, facility), effective Jan 1, 2026
  • IL: $145.48 (practitioner), effective Jan 1, 2016
  • IN: $148.94 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $791.32 (asc, facility), effective Jan 1, 2016
  • KY: $1702.62 (asc), effective Jan 1, 2026
  • LA: $265.13 (asc), effective Jan 1, 2016
  • MA: $1170.63 (asc), effective May 1, 2026
  • MS: $1348.14 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1003.70 (physician, facility), effective Aug 1, 2026
  • NE: $417.92 (physician, non-facility), effective Jul 1, 2026
  • NY: $127.40 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $189.69 (physician, facility), effective Jan 1, 2016
  • OK: $152.91 (physician, facility), effective Jul 1, 2026
  • TX: $1151.54 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $146.70 (medical, facility), effective Jul 1, 2026
  • VT: $2780.04 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1583.39 (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.