`C7501` Perc bx breast lesions stero

Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, all lesions unilateral and bilateral (for single lesion biopsy, use appropriate code)

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Outpatient hospital: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction

Payer policies and prior authorization for C7501

Payer coverage policies that name C7501

C7501 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Breast Biopsy Procedures (0269)	covered if criteria are met	May 14, 2026	payer document

Medicaid fee-for-service

IN: $0.00 (professional, facility), effective Jan 1, 2023
KS: $638.05 (asc, facility), effective Jan 1, 2023
KY: $1161.70 (asc), effective Jan 1, 2026
MA: $911.52 (asc), effective May 1, 2026
ND: $709.60 (physician, facility), effective Aug 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.

C7501 Perc bx breast lesions stero

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for C7501

Payer coverage policies that name C7501

Medicaid fee-for-service

`C7501` Perc bx breast lesions stero