67710 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 67710

Medicaid fee-for-service

  • AZ: $111.12 (asc), effective Oct 1, 2026
  • CO: $79.18 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $67.54 (physician, facility), effective Jan 1, 2026
  • IL: $91.96 (practitioner), effective Apr 1, 2024
  • IN: $75.35 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $225.00 (asc, facility), effective Aug 1, 1982
  • KY: $198.24 (asc), effective Jan 1, 2026
  • LA: $217.00 (asc), effective Jul 1, 2012
  • MA: $169.33 (asc), effective May 1, 2026
  • MS: $151.90 (comprehensive, facility), effective Oct 1, 2025
  • MT: $94.34 (optometric, facility), effective Jul 1, 2025
  • ND: $196.08 (physician, facility), effective Aug 1, 2026
  • NE: $42.57 (physician, facility), effective Jul 1, 2026
  • NY: $42.51 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $64.62 (physician, facility), effective Jan 1, 2024
  • OK: $180.86 (asc), effective Jan 1, 2026
  • TX: $170.54 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $75.23 (medical, facility), effective Jul 1, 2026
  • VT: $774.04 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $52.74 (physician, facility), effective Jul 1, 2026
  • WY: $440.86 (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.