C1737 Si&pelvis fusn&fixn dev

Joint fusion and fixation device(s), sacroiliac and pelvis, including all system components (implantable)

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for C1737

Payer coverage policies that name C1737

C1737 appears in 3 coverage policies from Blue Cross & Blue Shield of Mississippi, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
Blue Cross & Blue Shield of MississippiDiagnosis And Treatment Of Sacroiliac Joint Pain (L.6.01.413)covered if criteria are metpayer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Minimally Invasive Fixation/Fusion of the Sacroiliac Joint (SUR705.033)listed, no stanceNov 1, 2025payer document
Premera Blue CrossNon-covered Experimental/Investigational Serviceslisted, no stanceOct 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • KY: $0.00 (asc), effective Jan 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 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.