51700 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 51700

Payer coverage policies that name 51700

51700 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 50010-53899)Jul 30, 2026payer document
AetnaNeurogenic Bladder: Selected Treatments (0852)
Peripheral lidocaine application (neural therapy), Genital nerve stimulation		not coveredDec 23, 2025payer document

Medicaid fee-for-service

  • AZ: $30.85 (asc), effective Oct 1, 2026
  • CO: $58.51 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $20.45 (physician, facility), effective Jan 1, 2026
  • IL: $29.54 (practitioner), effective Apr 1, 2024
  • IN: $23.01 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $150.00 (asc, facility), effective Aug 1, 1982
  • KY: $55.05 (asc), effective Jan 1, 2026
  • LA: $70.41 (professional), effective Feb 1, 2013
  • MA: $44.48 (asc), effective May 1, 2026
  • MS: $41.40 (comprehensive, facility), effective Oct 1, 2025
  • ND: $54.45 (physician, facility), effective Aug 1, 2026
  • NE: $11.86 (physician, facility), effective Jul 1, 2026
  • NY: $22.57 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $25.61 (physician, facility), effective Jan 1, 2024
  • OK: $50.22 (asc), effective Jan 1, 2026
  • TX: $44.30 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $22.57 (medical, facility), effective Jul 1, 2026
  • VT: $194.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $15.10 (physician, facility), effective Jul 1, 2026
  • WY: $110.49 (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.