CPT 50220 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 |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50220 |
National average reimbursement for CPT 50220 by major payers:
$1,416.77
$1,404.88
$1,522.03
$1,741.04
| 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 50220 | ||||||
United | 50220 | $2575.00 | 1962626523 - CALLOWAY CREEK SURGERY CENTER LP | 141948102 - (TX) CALLOWAY CREEK SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $344.00 | 1306885256 - EYE SURGICAL CENTER, LLC, THE INSTITUTE FOR REFRACTIVE AND INTRAOCULAR SURGERY | 200318724 - (OH) EYE SURGICAL CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $467.00 | 1023343720 - HATTIESBURG SURGERY CENTER, LLC | 263789784 - (MS) HATTIESBURG SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $1064.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $63.00 | 1306134838 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $350.00 | 1417333295 - IDOX3 LLC, TRI-STATE SURGERY CENTER | 473757893 - (OH) IDOX3 LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $603.00 | 1598339392 - COPPER CITY SURGERY CENTER, PLLC | 831039743 - (MT) COPPER CITY SURGERY CENTER PLLC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $595.00 | 1285381004 - THE NEBRASKA AMBULATORY SURGICAL CENTER, LLC, THE NEBRASKA AMBULATORY SURGICAL CENTER | 872477902 - (NE) THE NEBRASKA AMBULATORY SURGICAL CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $857.23 | 1245800671 - DONNY LE | 350593390 - DEACONESS HOSPITAL INC | PA | Certified Registered Nurse Anesthetist (367500000X) |
United | 50220 | $275.00 | 1114312659 - UNITED SHOCKWAVE SERVICES, LTD., UNITED THERAPIES | 363415474 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50220 | $857.23 | 1982137428 - JENNIFER LAMPERT | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 50220 | $857.23 | 1578978557 - MELINDA CLARK | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 50220 | $857.23 | 1336541275 - WILLIAM SALINAS | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 50220 | $1865.76 | 1922193184 - REUBEN COHEN | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatric Critical Care Medicine Physician (2080P0203X) |
United | 50220 | $251.00 | 1033222989 - EMPIRE SURGERY CENTER | 770581233 - (CA) EMPIRE SURGERY CENTER | CA | 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 50220 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50220 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 50220 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 |
| 50080-CPT | High | Percutaneous Nephrolithotomy Or Pyelolithotomy Lithotripsy Stone Extraction Antegrade Ureteroscopy Antegrade Stent Placement And Nephrostomy Tube Placement When Performed Including Imaging Guidance; Simple (Eg Stone[S] Up To 2 Cm In Single Location Of Kidney Or Renal Pelvis Nonbranching Stones) (Desc Rvsd 1/1/23) |
| 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) |
| 50220-CPT | High | Nephrectomy W Part Ureterectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50220 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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