50686 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 50686

Payer coverage policies that name 50686

50686 appears in 1 coverage policy from Aetna.

Medicaid fee-for-service

• AZ: $41.01 (asc), effective Oct 1, 2026
• CO: $18.69 (chp_plus, non-facility), effective Jul 1, 2026
• FL: $62.60 (physician, facility), effective Jan 1, 2026
• IL: $64.10 (practitioner), effective Jul 1, 2026
• IN: $68.51 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
• KS: $109.02 (default, Exempt Physician), effective Jun 1, 2006
• KY: $72.61 (asc), effective Jan 1, 2026
• LA: $113.07 (professional), effective Jul 1, 2025
• MA: $59.42 (asc), effective May 1, 2026
• MS: $67.02 (comprehensive, facility), effective Oct 1, 2025
• ND: $42.80 (physician, facility), effective Aug 1, 2026
• NE: $6.51 (physician, facility), effective Jul 1, 2026
• NY: $45.01 (physician_surgery, facility), effective Jul 1, 2026
• OH: $32.49 (physician, facility), effective Dec 31, 2013
• OK: $71.53 (physician, facility), effective Jul 1, 2026
• TX: $57.79 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
• VA: $69.73 (medical, facility), effective Jul 1, 2026
• VT: $99.91 (outpatient_hospital_opps), effective Feb 1, 2026
• WA: $47.39 (physician, facility), effective Jul 1, 2026
• WY: $56.91 (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.