CPT 50225 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50225 |
National average reimbursement for CPT 50225 by major payers:
$1,711.24
$1,614.91
$1,665.79
$2,000.40
| 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 50225 | ||||||
United | 50225 | $580.00 | 1346349164 - SOUTHERN ALABAMA SURGERY CENTER LLC, SURGERY CENTER SOUTH | 621827534 - (AL) SOUTHERN ALABAMA SURGERY CENTER, LL | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $890.00 | 1619557519 - SCOTTSDALE MULTISPECIALTY SURGERY CENTER, PARADISE VALLEY MULTI SPECIALTY SURGERY CENTER | 833515797 - (AZ) SCOTTSDALE MULTISPECIALTY SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $1064.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $800.00 | 1659807717 - TAMPA SURGICAL CENTER LLC | 820715188 - (CA) TAMPA SURGICAL CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $4300.00 | 1861782591 - CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC, CAMIS | 270907140 - (NJ) CENTER FOR AMBULATORY AND MINI | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $441.00 | 1639452444 - CHILDREN'S AMBULATORY SURGERY CENTER OF NEW JERSEY, LLC | 271462884 - (NJ) CHILDRENS AMBULATORY SURGERY CENTER OF NEW JERSEY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $1167.00 | 1669574539 - MANCHESTER SURGERY CENTER, LLC | 205953313 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $2200.00 | 1871519314 - NORTHERN LITHO INC | 161511455 - (FL) NORTHERN LITHO, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $1064.00 | 1144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA | 871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $200.00 | 1568448660 - PROGRESSIVE SURGICAL INSTITUTE INC. | 232973820 - (PA) PROGRESSIVE SURGICAL INSTITUTE INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $2705.00 | 1568427151 - PLANO AMBULATORY SURGERY ASSOCIATES, LP | 621560420 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $447.00 | 1689604886 - SOUTH COUNTY OUTPATIENT SURGERY CENTER, LLC | 270133073 - (FL) SOUTH COUNTY OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $2575.00 | 1376507194 - COLUMBIA EYE AND SPECIALTY SURGERY CENTER LTD | 752528760 - (FL) COLUMBIA EYE AND SPECIALTY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $170.00 | 1134499684 - CHILDRENS SURGERY CENTER OF MALVERN, LLC | 452608984 - (PA) CHILDRENS SURGERY CENTER OF MALVERN LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50225 | $430.00 | 1457640112 - MID-MICHIGAN ENDOSCOPY CENTER, PLLC, CHARTER ENDOSCOPY CENTER | 201979186 - (MI) MID MICHIGAN ENDOSCOPY CENTER | 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 50225 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50225 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 50225 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 |
|---|---|---|
| 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 |
| 50230-CPT | High | Nephrectomy, Including Partial Ureterectomy, Any Open Approach Including Rib Resection; Radical, With Regional Lymphadenectomy And/Or Vena Caval Thrombectomy |
| 50240-CPT | High | Nephrectomy Partial |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50225 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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