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CPT 50120 Fee Schedule

Last Verified: November 2025

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.

Pyelotomy W Exploration
Key FactDetail
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

79 - Unrelated procedure - postop period

Complexity LevelHigh
CMS$921.23 Physician Fee Schedule

National average reimbursement for CPT 50120 by major payers:

bcbs

$1,297.48

uhc

$1,278.30

aetna

$1,305.14

cigna

$1,582.45

Preview provider-level rates for...
For billing codeCPT 50120
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 50120

United
50120$1670.001629664156 - OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER, OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER NEW ALBANY854149946 - (OH) OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTEROHAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$487.001447225503 - BAPTIST DESOTO SURGERY CENTER, LP200804946 - (MS) BAPTIST DESOTO SURGERY CENTER LPMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$1187.001649208679 - AKRON SURGICAL ASSOCIATES, LLC, THE SURGERY CENTER AT AKRON GENERAL HEALTH & WELLNESS CENTER10672877 - (OH) AKRON SURGICAL ASSOCIATES LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$3563.001619971082 - KU MEDWEST AMBULATORY SURGERY CENTER, LLC20664568 - (KS) KU MEDWEST AMBULATORY SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$520.001902849227 - EYE SURGERY CENTER, LLC371221499 - (IL) EYECARE MANAGEMENT, LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$671.001295463990 - SHARPEVISION PLLC454849447 - (WA) SHARPEVISION, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$6500.001437459617 - UNION HEALTH SERVICES, LLC, ATRIUM HEALTH SURGERY CENTER INDIAN TRAIL300597871 - (NC) UNION HEALTH SERVICES LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$1114.001023551413 - MID-BRONX ENDOSCOPY CENTER LLC471156630 - (NY) MIDBRONX ENDOSCOPY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$600.001396123865 - SOUND SURGEONS PLLC, NORTHWEST WEIGHT LOSS SURGERY461190829 - (WA) SOUND SURGEONS, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$1049.001336142413 - TEXAN AMBULATORY SURGERY CENTER, LP331058382TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$1000.001740337435 - DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER, DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER342064423 - (CA) DIAGNOSTIC AND INTERVENTIONAL SURGERY CENTER, LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$5658.001013548833 - ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT LLC, ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT843972619 - (WI) ASCENSION WISCONSIN SURGERY CENTERMOUNT PLEASANT LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$1028.001184125809 - SUMMIT AMBULATORY SURGICAL CENTER LLC522148280MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$100.001790172922 - YUMA VALLEY AMBULATORY PAIN SERVICES INC471779727 - (AZ) YUMA VALLEY AMBULATORY PAIN SERVICES INCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
50120$728.001093716037 - CATARACT AND REFRACTIVE SURGERY CENTER, LLC, NOVAMED SURGERY CENTER OF RICHMOND, LLC621865972 - (VA) CATARACT AND REFRACTIVE SURGERY CENTER LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 50120 vs. Other Surgical Procedures on the Urinary System Codes

The CPT 50120 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 50120 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.

CodeComplexityDescription
50010-CPTModerateExploration Renal
50020-CPTHighDrain Abscess Renal/Perirenal
50040-CPTHighNephrostomy
50120-CPTHighPyelotomy W Exploration

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 50120 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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