C7544 Ercp rmv calc pancreatoscopy

Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s)

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for C7544

Payer coverage policies that name C7544

C7544 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaDouble Balloon Enteroscopy (0737)listed, no stanceNov 13, 2025payer document
AetnaNerve Blocks (0863)listed, no stance (range C7541-C7544)Jul 23, 2026payer document

Medicaid fee-for-service

  • IN: $0.00 (professional, facility), effective Jan 1, 2023
  • KS: $1352.47 (asc, facility), effective Jan 1, 2023
  • ND: $0.00 (physician), 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.