Payer policies › CPT 6733167331 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 67331 Payer coverage policies that name 67331 67331 appears in 3 coverage policies from Aetna, Anthem.
Payer Policy Role in policy Reviewed Document Aetna Graves' Ophthalmopathy Treatments (0419) covered if criteria are met (range 67311-67343) Apr 23, 2026 payer document Aetna Strabismus Repair (0566) covered if criteria are met Aug 6, 2026 payer document Anthem Surgical Strabismus Correction (CG-SURG-41) covered if criteria are met Nov 6, 2025 payer document
Medicaid fee-for-service Prior authorization required or conditional in WA, WV.
AZ: $1733.49 (outpatient_hospital), effective Oct 1, 2013 CO: $102.43 (chp_plus, non-facility), effective Jul 1, 2026 FL: $129.56 (physician, non-facility), effective Jan 1, 2026 IL: $145.89 (practitioner), effective Apr 1, 2024 IN: $96.93 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $350.00 (asc, facility), effective Aug 1, 1982 KY: $0.00 (asc), effective Jan 1, 2026 LA: $217.00 (asc), effective Jul 1, 2012 MA: $0.00 (asc), effective May 1, 2026 MS: $85.73 (comprehensive), effective Jul 1, 2026 MT: $120.46 (optometric, facility), effective Jul 1, 2025 ND: $109.64 (physician), effective Aug 1, 2026 NE: $785.00 (asc), effective Jul 1, 2024 NY: $242.40 (physician_surgery, facility), effective Jul 1, 2026 OH: $220.12 (physician), effective Jul 1, 2002 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $316.41 (physician, Physician, facility), effective Jul 1, 2010 VA: $87.38 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $59.81 (physician, facility), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.