Payer PolicyActive
Athletic Pubalgia Surgery
AETNA-CPB-0750
Aetna
Effective: October 6, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna considers surgical treatments for athletic pubalgia — including pelvic floor repair, pulse‑dose radiofrequency, and intra‑tissue percutaneous electrolysis — experimental/investigational and not covered. Diagnosis is clinical (history and physical), the policy lists no covered surgical indications, there is no specific CPT code for athletic pubalgia surgery, and related ICD‑10 codes (R10.30‑R10.33, S39.013+, S39.83X+) are not covered.
Coverage Criteria Preview
Key requirements from the full policy
""Pulse-dose radiofrequency for the treatment of athletic pubalgia," (is considered experimental and investigational)."
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