Payer policies › CPT 5173651736 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 51736 Payer coverage policies that name 51736 51736 appears in 2 coverage policies from Aetna, Centene.
Payer Policy Role in policy Reviewed Document Aetna Bupivacaine Liposome (Exparel) (0941) listed, no stance (range 50010-53899) Jul 30, 2026 payer document Centene Urodynamic Testing (CP.MP.98) covered if criteria are met Mar 1, 2023 payer document
Medicaid fee-for-service AZ: $81.16 (outpatient_hospital), effective Oct 1, 2021 CO: $4.76 (chp_plus, non-facility), effective Jul 1, 2026 FL: $4.68 (physician), effective Jan 1, 2026 IL: $13.04 (practitioner), effective Apr 1, 2024 IN: $6.33 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $184.43 (asc, facility), effective Aug 1, 1982 KY: $0.00 (asc), effective Jan 1, 2026 LA: $14.59 (professional), effective Feb 1, 2013 MA: $0.00 (asc), effective May 1, 2026 MS: $7.36 (comprehensive), effective Jul 1, 2026 ND: $9.39 (physician), effective Aug 1, 2026 NE: $44.46 (physician, non-facility), effective Jul 1, 2026 NY: $41.12 (physician_surgery, facility), effective Jul 1, 2026 OH: $13.35 (physician), effective Sep 1, 2013 OK: $4.99 (physician, non-facility), effective Jul 1, 2026 TX: $10.59 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2025 VA: $7.52 (medical), effective Jul 1, 2026 VT: $103.31 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $5.16 (physician, facility), effective Jul 1, 2026 WY: $58.84 (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.