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See a sample rate comparisonCPT 50040 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Nephrostomy
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50040 |
| Medicaid Fee Schedule | View Medicaid rates for 50040 |
National average reimbursement for CPT 50040 by major payers:
$1,302.74
$1,242.21
$1,285.47
$1,509.02
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CPT 50040
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, LLC, Multispecialty Surgery Center
$8,705.00Published rateCentennial Asc, LLC, Baylor Surgicare At Centennial
Centennial Asc LLC
$3,500.00Published rateChandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center
$2,307.00Published rateMetairie Ophthalmology Asc LLC, Ambulatory Eye Surgery Center Of Louisiana
The Metairie Ophthalmology Asc, LLC Dba Ambulatory Eye Surgery Center
$1,172.00Published rateCharleston Endoscopy Center
$497.00Published rate
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See a sample payer proposalCPT 50040 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50040 code is part of the Surgery services used for Surgical Procedures on the Urinary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 50040 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50040 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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