52282 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 52282

3 of 3 payer prior-auth lists that name 52282 require prior authorization or set conditions: Humana, Neighborhood Health Partnership, UnitedHealthcare.

PayerPlanStatePrior authConditionsSinceSource
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification
Neighborhood Health PartnershipNeighborhood Health PartnershipFLprior auth under conditionssite of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WISep 1, 2026Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth under conditionssite of care: outpatient hospitalSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026

Payer coverage policies that name 52282

52282 appears in 3 coverage policies from Aetna, BlueCross BlueShield of South Carolina.

PayerPolicyRole in policyReviewedDocument
AetnaBenign Prostatic Hyperplasia (0079)covered if criteria are metApr 15, 2026payer document
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 50010-53899)Jul 30, 2026payer document
BlueCross BlueShield of South CarolinaSurgical and Minimally Invasive Treatments for Urinary Outlet Obstruction Due to Benign Prostatic Hyperplasia (BPH) (CAM 139)listed, no stanceMar 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, Oxford Health Plans
  • Oct 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Aug 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, Neighborhood Health Partnership

Medicaid fee-for-service

  • AZ: $1171.31 (asc), effective Oct 1, 2026
  • CO: $271.05 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $230.94 (physician, non-facility), effective Jan 1, 2026
  • IL: $229.38 (practitioner), effective Apr 1, 2024
  • IN: $257.47 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $350.00 (asc, facility), effective Jan 1, 1998
  • KY: $1681.93 (asc), effective Jan 1, 2026
  • LA: $265.13 (asc), effective Jul 1, 2012
  • 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: $637.00 (asc), effective Jul 1, 2024
  • NY: $172.17 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $306.49 (physician), effective Jan 1, 2000
  • OK: $1534.46 (asc), effective Jan 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: $257.23 (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.