CPT 50234 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 50234 |
National average reimbursement for CPT 50234 by major payers:
$1,841.31
$1,753.65
$1,840.94
$2,165.94
| 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 50234 | ||||||
United | 50234 | $122.00 | 1386794980 - NEW VISION CATARACT CENTER LLC, NEW VISION CATARACT CENTER | 61557487 - (CT) NEW VISION CATARACT CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $482.00 | 1427020213 - TOLEDO ENDOSCOPY ASC LLC, NORTHWEST OHIO ENDOSCOPY CENTER | 621734002 - (OH) TOLEDO ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $1965.00 | 1972805299 - ST. VINCENT'S OUTPATIENT SURGERY SERVICES LLC | 200708162 - (AL) ST VINCENTS OUTPATIENT SURGERY SERVICES LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $402.00 | 1003889346 - ENDOSCOPY GROUP LLC | 593519881 - (FL) ENDOSCOPY GROUP, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $796.00 | 1871007880 - SOUTHWEST ENDOSCOPY PARTNERS LLC | 822948062 - (CO) SOUTHWEST ENDOSCOPY PARTNERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $109.00 | 1851516728 - PHOENIX ENDOSCOPY LLC | 710940187 - (AZ) PHOENIX ENDOSCOPY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $747.00 | 1093069452 - UROLOGY SPECIALISTS SURGERY CENTER, LLC | 460876134 - (GA) UROLOGY SPECIALISTS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $490.00 | 1629443478 - SCOTTSDALE MCCORMICK RANCH SURGICENTER LLC | 475123911 - (AZ) SCOTTSDALE MCCORMICK RANCH SURGICENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $607.00 | 1437642857 - GEORGIA VASCULAR & VEIN CENTER | 822239594 - (GA) GEORGIA VASCULAR VEIN CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $386.00 | 1215957816 - SURGERY CENTER OF CENTRAL VIRGINIA INC., D.B.A. EYE SURGERY CENTER | 541816412 - (VA) SURGERY CENTER OF CENTRAL VIRGINIA INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $1049.00 | 1275292229 - SCOTTSDALE ENDOSCOPY ASC LLC | 873952617 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $350.00 | 1639215502 - BOSTON EYE SURGERY & LASER CENTER TRUST, BOSTON EYE SURGERY & LASER CENTER | 43092292 - (MA) BOSTON EYE SURGERY & LASER CENTER TRUST | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $410.00 | 1457674236 - CORM SURGICENTER | 260681153 - (TX) CORM SURGICENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $580.00 | 1750884052 - PRECISION SURGERY CENTER PLLC | 824729968 - (ID) PRECISION SURGERY CENTER PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50234 | $1955.00 | 1023420577 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY | 470985876 | TX | 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 50234 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50234 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 50234 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 |
| 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 |
| 50250-CPT | High | Ablation, Open 1 Or More Renal Mass Lesion(S) Cryosurgical Including Intraoperative Ultrasound Guidance & Monitoring If Performed- Rn Review >=11/14/2009 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50234. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50234 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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