77072 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 77072

Payer coverage policies that name 77072

77072 appears in 4 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi.

PayerPolicyRole in policyReviewedDocument
AetnaBone and Tendon Graft Substitutes and Adjuncts (0411)listed, no stanceAug 18, 2026payer document
AetnaIdiopathic Scoliosis (0398)listed, no stanceSep 28, 2026payer document
AetnaWeight Reduction Programs and Devices (0039)listed, no stanceMar 10, 2026payer document
Blue Cross & Blue Shield of MississippiFoot Care Services (L.9.01.401)covered if criteria are metpayer document

Medicaid fee-for-service

  • AZ: $79.00 (outpatient_hospital), effective Oct 1, 2021
  • CO: $14.12 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $10.68 (radiology), effective Jan 1, 2026
  • IL: $21.50 (practitioner), effective Apr 1, 2024
  • IN: $19.69 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $15.50 (default, Exempt Physician), effective Jan 1, 2024
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $8.05 (lab_radiology), effective Jul 1, 2025
  • MA: $6.73 (physician_radiology), effective May 1, 2024
  • MS: $79.39 (comprehensive), effective Jul 1, 2026
  • ND: $18.02 (physician), effective Aug 1, 2026
  • NE: $16.82 (physician, non-facility), effective Jul 1, 2026
  • NY: $15.15 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $15.82 (physician), effective Jan 1, 2024
  • OK: $94.14 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $131.99 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2025
  • VA: $21.99 (medical), effective Jul 1, 2026
  • VT: $81.18 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $5.35 (physician, facility), effective Jul 1, 2026
  • WY: $46.23 (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.