73620 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 73620

Payer coverage policies that name 73620

73620 appears in 4 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi.

PayerPolicyRole in policyReviewedDocument
AetnaBunionectomy (0629)listed, no stanceSep 11, 2026payer document
AetnaComplex Regional Pain Syndrome (CRPS): Diagnosis (0147)not covered (range 73501-73660)Mar 30, 2026payer document
AetnaHammertoe Repair (0636)listed, no stance (range 73620-73630)Sep 11, 2026payer document
Blue Cross & Blue Shield of MississippiFoot Care Services (L.9.01.401)covered if criteria are met (range 73620-73725)payer document

Medicaid fee-for-service

Prior authorization required or conditional in WV.

  • AZ: $58.65 (outpatient_hospital), effective Oct 1, 2021
  • CO: $23.80 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $13.63 (radiology), effective Jan 1, 2026
  • IL: $17.00 (podiatrist), effective Apr 1, 2024
  • IN: $21.65 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $4.54 (default, Exempt Physician), effective Jan 1, 2024
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $8.81 (lab_radiology), effective Jul 1, 2025
  • MA: $16.81 (physician_radiology), effective May 1, 2024
  • MS: $66.09 (comprehensive), effective Jul 1, 2026
  • ND: $23.28 (physician), effective Aug 1, 2026
  • NE: $34.34 (physician, non-facility), effective Jul 1, 2026
  • NY: $10.10 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $19.77 (physician), effective Jan 1, 2024
  • OK: $17.56 (physician, non-facility), effective Jul 1, 2026
  • TX: $109.09 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2025
  • VA: $24.88 (medical), effective Jul 1, 2026
  • VT: $67.57 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $13.19 (physician, facility), effective Jul 1, 2026
  • WY: $38.49 (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.