CPT 50075 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50075 |
National average reimbursement for CPT 50075 by major payers:
$1,953.39
$1,965.64
$2,013.19
$2,425.12
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 50075 | ||||||
United | 50075 | $372.00 | 1386681161 - SUNCOAST SPECIALTY SURGERY CENTER, LLLP | 204570672 - (FL) SUNCOAST SPECIALTY SURGERY CENTER LLLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $1150.00 | 1902805278 - EAST METRO ASC LLC, HIGH POINTE SURGERY CENTER | 411890436 - (MN) HIGH POINTE SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $450.00 | 1053388223 - THE OCULAR SURGERY CENTER, LLC | 742462970 - (TX) THE OCULAR SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $712.00 | 1619576824 - SURGICARE OF LA VETA, LTD., NEWPORT COAST SURGICAL INSTITUTE | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $1337.00 | 1659443042 - HALLANDALE OUTPATIENT SURGICAL CENTER,LTD | 200244303 - (FL) HALLANDALE OUTPATIENT SURGICAL CENTERLTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $2575.00 | 1275536393 - MEDICAL CENTER SURGERY ASSOCIATES, LP | 621449272 - (FL) MEDICAL CENTER SURGERY ASSOCIATES LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $2575.00 | 1790130672 - PROSPECT DCMH, LLC, SHORT PROCEDURE UNIT | 811520273 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $16236.00 | 1396774543 - WISCONSIN SURGERY CENTER LLC | 383661215 - (WI) WISCONSIN SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $2732.00 | 1922075167 - NORTH CENTRAL METHODIST ASC, LP, METHODIST AMBULATORY SURGERY CENTER NORTH CENTRAL | 742998447 - (TX) NORTH CENTRAL METHODIST ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $629.00 | 1477617751 - COLUMBIA SURGICAL SPECIALISTS, PS, COLUMBIA SURGERY CENTER | 910867604 - (WA) COLUMBIA SURGICAL SPECIALISTS, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $1028.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $318.00 | 1063415891 - HARRISON SURGERY CENTER, LLC | 201117764 - (AR) HARRISON SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $529.00 | 1174679054 - CROSSROADS SURGERY CENTER, LLC | 562622609 - (TN) CROSSROADS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $850.00 | 1124406632 - COMPREHENSIVE PAIN ASC, LLC | 473944400 - (CA) COMPREHENSIVE PAIN ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50075 | $1124.00 | 1962938332 - BANNER UNION HILLS SURGERY CENTER LLC | 901164193 - (AZ) BANNER UNION HILLS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 50075 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50075 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 50075 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 |
|---|---|---|
| 50065-CPT | High | Nephrolithotomy Secondary |
| 50070-CPT | High | Nephrolithotomy;Complicated-Congen.Kidne |
| 50075-CPT | High | Nephrolithotomy; Removal Of Large Staghorn Calculus Filling Renal Pelvis And Calyces (Including Anatrophic Pyelolithotomy) |
| 50081-CPT | High | 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) (Desc Rvsd 1/1/23) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50075. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50075 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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