C8014 Cysto, litho, w suct sheath

Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed)

Payer policies and prior authorization for C8014

Payer coverage policies that name C8014

C8014 appears in 1 coverage policy from Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
Premera Blue CrossNon-covered Experimental/Investigational Services
Page | 30 of 38 | ∞		listed, no stanceOct 1, 2026payer document

Medicaid fee-for-service

  • AZ: $2372.96 (asc), effective Oct 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $4163.23 (outpatient_hospital_opps), effective Jul 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.