Payer policies › CPT 4778047780 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 47780 1 of 1 payer prior-auth lists that name 47780 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas.
Payer coverage policies that name 47780 47780 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Double Balloon Enteroscopy (0737) listed, no stance Nov 13, 2025 payer document
Medicaid fee-for-service AZ: $2518.44 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $1934.91 (chp_plus, non-facility), effective Jul 1, 2026 FL: $2476.87 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025 IL: $1749.27 (practitioner), effective Apr 1, 2024 IN: $1847.98 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $643.12 (default, Exempt Physician), effective Aug 1, 2024 KY: $1015.51 (physician, facility), effective Jan 1, 2026 LA: $2019.58 (professional), effective Jul 1, 2025 MA: $1805.13 (physician_surgery), effective May 1, 2024 MS: $1903.03 (comprehensive), effective Jul 1, 2026 ND: $2331.81 (physician), effective Aug 1, 2026 NE: $1956.24 (physician, non-facility), effective Jul 1, 2026 NY: $1052.19 (physician_surgery, facility), effective Jul 1, 2026 OH: $1273.16 (physician), effective Jan 1, 2024 OK: $2009.17 (physician, non-facility), effective Jul 1, 2026 TX: $269.02 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1978.30 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $1313.62 (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.