67830 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 67830

Medicaid fee-for-service

  • AZ: $326.88 (asc), effective Oct 1, 2026
  • CO: $221.11 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $94.45 (physician, facility), effective Jan 1, 2026
  • IL: $112.60 (practitioner), effective Jul 1, 2026
  • IN: $106.14 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $175.00 (asc, facility), effective Aug 1, 1982
  • KY: $530.35 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $346.59 (asc), effective May 1, 2026
  • MS: $396.78 (comprehensive, facility), effective Oct 1, 2025
  • MT: $132.78 (optometric, facility), effective Jul 1, 2025
  • ND: $312.64 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $141.40 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $72.37 (physician, facility), effective Jan 1, 2024
  • OK: $483.85 (asc), effective Jan 1, 2026
  • TX: $335.22 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $103.30 (medical, facility), effective Jul 1, 2026
  • VT: $774.04 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), 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.