50570 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 50570

Payer coverage policies that name 50570

50570 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 50010-53899)Jul 30, 2026payer document

Medicaid fee-for-service

  • AZ: $1171.31 (asc), effective Oct 1, 2026
  • CO: $74.84 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $334.58 (physician, non-facility), effective Jan 1, 2026
  • IL: $334.39 (practitioner), effective Apr 1, 2024
  • IN: $375.21 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $300.00 (asc, facility), effective Aug 1, 1982
  • KY: $1681.93 (asc), effective Jan 1, 2026
  • LA: $429.41 (professional), effective Feb 1, 2013
  • MA: $1170.42 (asc), effective May 1, 2026
  • MS: $1324.25 (comprehensive, facility), effective Oct 1, 2025
  • ND: $991.50 (physician, facility), effective Aug 1, 2026
  • NE: $866.96 (physician, non-facility), effective Jul 1, 2026
  • NY: $252.72 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $313.88 (physician), effective Jan 1, 2024
  • OK: $386.40 (physician, non-facility), effective Jul 1, 2026
  • TX: $1142.90 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $372.69 (medical), effective Jul 1, 2026
  • VT: $2737.01 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1558.88 (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.