Payer policies › CPT 4771547715 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 47715 Medicaid fee-for-service AZ: $1360.51 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $1048.21 (chp_plus, non-facility), effective Jul 1, 2026 FL: $1339.15 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025 IL: $938.45 (practitioner), effective Apr 1, 2024 IN: $997.93 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $463.26 (default, Exempt Physician), effective Aug 1, 2024 KY: $687.51 (physician, facility), effective Jan 1, 2026 LA: $1084.52 (professional), effective Jul 1, 2025 MA: $979.56 (physician_surgery), effective May 1, 2024 MS: $1039.32 (comprehensive), effective Jul 1, 2026 ND: $1284.56 (physician), effective Aug 1, 2026 NE: $1630.20 (physician, non-facility), effective Jul 1, 2026 NY: $591.41 (physician_surgery, facility), effective Jul 1, 2026 OH: $705.81 (physician), effective Jan 1, 2024 OK: $1098.34 (physician, non-facility), effective Jul 1, 2026 TX: $147.71 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1086.23 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $724.84 (physician, facility), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.