CPT 50230 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 |
| CMS | $1,236.93 Physician Fee Schedule |
National average reimbursement for CPT 50230 by major payers:
$1,724.94
$1,728.49
$1,880.37
$2,132.80
| 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 50230 | ||||||
United | 50230 | $248.00 | 1104468602 - PRESBYTERIAN HOSPITAL ASC, NEW MEXICO SURGERY CENTER MULTI-SPECIALTY | 842748057 | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $517.00 | 1174520191 - AESTHETIC SURGERY CENTER OF EUGENE INC | 931320547 - (OR) AESTHETIC SURGERY CENTER OF EUGENE INC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $840.00 | 1013309459 - MELBOURNE SURGERY CENTER, LLC, MELBOURNE SURGERY CENTER | 582101921 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $424.00 | 1649322496 - SURGICARE SURGICAL ASSOCIATES OF ORADELL, LLC | 200626574 - (NJ) SURGICARE SURGICAL ASSOCIATES OF ORADELL LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $2732.00 | 1487059002 - RIVERWALK ASC, LLC, RIVERWALK ASC | 472075991 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $1064.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $2945.00 | 1629249172 - NORTH STATE SURGERY CENTERS LP, COURT STREET SURGERY CENTER | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $650.00 | 1679595680 - SURGERY CENTER OF LEBANON, LP, PHYSICIANS SURGICAL CENTER | 721588584 - (PA) SURGERY CENTER OF LEBANON LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $747.00 | 1093069452 - UROLOGY SPECIALISTS SURGERY CENTER, LLC | 460876134 - (GA) UROLOGY SPECIALISTS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $5387.00 | 1497244149 - HOSPITAL FOR SPECIAL SURGERY WEST SIDE AMBULATORY SURGERY CENTER, LLC, HSS WEST SIDE ASC, LLC | 814351390 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $1064.00 | 1740260926 - STARK AMBULATORY SURGERY CENTER, LLC | 611448511 - (OH) STARK AMBULATORY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $1264.00 | 1497068761 - CARNEGIE HILL ENDOSCOPY LLC | 270385539 - (NY) CARNEGIE HILL ENDOSCOPY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $300.00 | 1184675704 - DOCTORS SURGERY CENTER LLC | 593518740 - (FL) DOCTORS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $380.00 | 1396852570 - EAGLE PHYSICIANS AND ASSOCIATES PA, EAGLE ENDOSCOPY CENTER | 561847193 - EAGLE PHYSICIANS & ASSOCIATES, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50230 | $215.00 | 1871644823 - PERLOW FACILITY, LLC | 251926011 - (GA) PERLOW FACILITY LLC | GA | 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 50230 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50230 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 50230 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 |
|---|---|---|
| 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 |
| 50234-CPT | High | Nephrectomy W Ureterect Same Incis |
| 50300-CPT | High | Nephrectomy Cadaver Donor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50230. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50230 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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