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See a sample rate comparisonCPT 50065 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.
Nephrolithotomy Secondary
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50065 |
| Medicaid Fee Schedule | View Medicaid rates for 50065 |
National average reimbursement for CPT 50065 by major payers:
$1,603.66
$1,615.83
$1,655.99
$1,958.73
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CPT 50065
5 of 25 sample ratesHigher to lower in this preview
Ophthalmology Surgery Center Of Dallas, LLC
Ophthalmology Surgery Center Of Dallas
$6,068.00Published ratePioneer Valley Surgicenter LLC, Pioneer Valley Surgicenter
Pioneer Valley Surgicenter, LLC
$1,056.00Published rateNortheast Georgia Urological Surgery Center, LLC
Northeast Georgia Urological Surgery Center LLC
$775.00Published rateFlorida Orthopaedic Institute Surgery Center LLC
$550.00Published rateSurgical Specialty Suites, Inc
Surgical Specialty Suites Inc
$120.00Published rate
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See a sample payer proposalCPT 50065 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50065 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 50065 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.
| Code | Complexity | Description |
|---|---|---|
| 50060-CPT | High | Nephrolithotomy; Removal Of Calculus |
| 50065-CPT | High | Nephrolithotomy Secondary |
| 50075-CPT | High | Nl Rmvl Lg Staghorn Calculus, Nephrolithotomy; Removal Of Large Staghorn Calculus Filling Renal Pelvis And Calyces (Including Anatrophic Pyelolithotomy) |
| 50081-CPT | High | Perq Nl Pl Lithotrp Cplx 2cm, Percutaneous Nephrolithotomy Or Pyelolithotomy Lithotripsy Stone Extraction Antegrade Ureteroscopy Antegrade Stent Placement And Nephrostomy Tube Placement When Performed Including Imaging Guidance Complex Eg Stone S 2 Cm Branching Stones Stones In Multiple Locations Ureter Stones Complicated Anatomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50065 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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