CPT 50236 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 • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| CMS | $1,413.87 Physician Fee Schedule |
National average reimbursement for CPT 50236 by major payers:
$1,957.38
$1,975.59
$2,018.54
$2,440.48
| 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 50236 | ||||||
United | 50236 | $1003.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $225.00 | 1124484019 - EDISON SURGERY CENTER LLC | 475016492 - (NJ) EDISON SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $228.00 | 1013222926 - CARLIN VISION SURGERY CENTER LLC | 272799561 - (GA) CARLIN VISION SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $1064.00 | 1588610190 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $327.00 | 1538109384 - PLASTIC SURGERY SPECIALISTS, PC | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $623.00 | 1417566217 - CLEARWAY SURGERY CENTER OF EASTON, LLC | 851826166 - (MD) CLEARWAY SURGERY CENTER OF EASTON LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $699.00 | 1023182581 - MAYS & SCHNAPP PAIN CLINIC & REHABILITATION CENTER | 621512849 - (TN) MAYS SCHNAPP PAIN CLINIC REHABILITATION CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $335.00 | 1164719209 - SURGICAL SPECIALISTS OF ST LUCIE, BLUE WATER SURGERY CENTER | 260176703 - (FL) SURGICAL SPECIALISTS OF ST. LUCIE COUNTY, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $1477.00 | 1669021283 - EL DORADO SURGERY CENTER LP, TUCSON ENDOSCOPY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $762.00 | 1902964174 - 4TH STREET LASER & SURGERY CENTER INC | 943333271 - (CA) FOURTH STREET LASER & SURGERY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $780.00 | 1750378295 - BRAINERD LAKES SURGERY CENTER L L C | 200113449 - (MN) BRAINERD LAKES SURGERY CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $496.00 | 1821219718 - WASHINGTON SURGERY CENTER, LLC, WASHINGTON SURGERY CENTER, INC. | 412110716 - (MO) WASHINGTON SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $695.00 | 1245399757 - KUMAR SURGICAL CENTER LLC | 383530839 - (MI) KUMAR SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $630.00 | 1871538694 - SOUTHWEST ENDOSCOPY LTD | 850452091 - (NM) SOUTHWEST ENDOSCOPY LTD | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $650.00 | 1407824436 - ORAL FACIAL SURGERY CENTER, LLC, SPECIALTY SURGERY CENTER | 621488965 - (TN) ORAL FACIAL SURGERY CENTER, INC. | TN | 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 50236 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50236 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 50236 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 |
|---|---|---|
| 50230-CPT | High | Nephrectomy, Including Partial Ureterectomy, Any Open Approach Including Rib Resection; Radical, With Regional Lymphadenectomy And/Or Vena Caval Thrombectomy |
| 50236-CPT | High | Nephrectomy W Ureterect Sep Incis |
| 50240-CPT | High | Nephrectomy Partial |
| 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 50236. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50236 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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