CPT 50205 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 |
| Common Modifiers | • None • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 50205 |
National average reimbursement for CPT 50205 by major payers:
$974.02
$994.21
$1,065.09
$1,229.67
| 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 50205 | ||||||
United | 50205 | $375.00 | 1740876671 - FRESENIUS VASCULAR CARE DAYTON ASC LLC | 852997056 - (OH) FRESENIUS VASCULAR CARE DAYTON ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $105.00 | 1831238773 - CORPUS CHRISTI ENDOSCOPY CENTER LLP, CORPUS CHRISTI ENDOSCOPY CENTER | 202595593 - (TX) CORPUS CHRISTI ENDOSCOPY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $450.00 | 1447600416 - POTTSTOWN AMBULATORY CENTER, LLC | 474556636 - (PA) POTTSTOWN AMBULATORY CENTER LL | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $135.00 | 1407539539 - RSC SURGERY CENTER, LLC | 352345966 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $983.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $536.00 | 1518450790 - VIRGINIA ENT SURGERY CENTER INC | 541052755 - (VA) VIRGINIA EAR, NOSE & THROAT ASSOCIATES, P.C. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $983.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $1274.00 | 1285768903 - SURGERY CENTER OF RENO, LLC, SWIFT SURGERY CENTER LLC | 203707845 - (NV) SURGERY CENTER OF RENO, LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $700.00 | 1285083477 - GEORGIA INTERVENTIONAL PAIN | 810948119 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $1064.00 | 1467601625 - MNH GI SURGICAL CENTER LLC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $732.00 | 1619998523 - UPSTATE SURGERY CENTER, LLC | 562186977 - (SC) UPSTATE SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $553.00 | 1346912250 - SOUTHEAST EYE LASER SURGERY CENTER | 853785035 - (GA) SOUTHEAST EYE LASER SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $520.00 | 1104868561 - REGIONAL SURGERY CENTER, P.C. | 431527254 - (MO) REGIONAL SURGERY CENTER PC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $652.04 | 1417916800 - TULSA OK ENDOSCOPY ASC LLC, TULSA ENDOSCOPY CENTER | 203853559 - (OK) TULSA ENDOSCOPY CENTER, LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50205 | $780.00 | 1467544684 - TOWNE CENTRE SURGERY CENTER, LLC, ST. MARY'S OF MICHIGAN | 204943843 | MI | 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 50205 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50205 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 50205 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 |
|---|---|---|
| 50200-CPT | Moderate | Needle Biopsy Of Kidney, Accessed Through The Skin |
| 50205-CPT | Moderate | Biopsy Renal Surgical Exposure |
| 50220-CPT | High | Nephrectomy W Part Ureterectomy |
| 50225-CPT | High | Nephrectomy, Including Partial Ureterectomy, Any Open Approach Including Rib Resection; Complicated Because Of Previous Surgery On Same Kidney |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50205. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50205 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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