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 |
| Medicare Fee Schedule | View Medicare rates for 50236 |
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 | $1970.00 | 1528104080 - SURGICAL CENTER AT CEDAR KNOLLS LLC | 202158771 - (NJ) SURGICAL CENTER AT CEDAR KNOLLS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $858.00 | 1619245230 - AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | 800768614 - (NJ) AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $1028.00 | 1902807159 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF SCOTTSDALE | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $496.00 | 1154352847 - ATLANTA SURGERY CENTERS, ATLANTA SURGERY CENTERS | 270318863 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $147.00 | 1770753998 - SKIN CANCER TREATMENT CENTER, L.L.C. | 262051034 - (MD) SKIN CANCER TREATMENT CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $608.00 | 1306093604 - BOX CANYON SURGERY CENTER LLC | 263086826 - (NV) BOX CANYON SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $1061.00 | 1598039125 - ROOSEVELT SURGERY CENTER, LLC | 271778024 - (NY) ROOSEVELT SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $225.00 | 1770599136 - RADIANCE-A PRIVATE OUTPATIENT SURGERY CENTER LLC, RADIANCE SURGERY CENTER | 510465402 - (PA) RADIANCE, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $255.00 | 1184948663 - ASSOCIATED UROLOGISTS AMBULATORY SURGERY CENTER LLC | 272200221 - (KS) ASSOCIATED UROLOGISTS AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $852.00 | 1609871847 - THE SURGERY CENTER, LLC | 582520623 - (GA) THE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $645.00 | 1548837503 - HOUSTON IVF MANAGEMENT | 841602243 - (TX) HOUSTON IVF MANAGEMENT CO., LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $503.00 | 1932183266 - SINGLE DAY SURGERY CENTER LLC | 880504513 - (NV) SINGLE DAY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $1028.00 | 1881697522 - RIVERSIDE PARK SURGICENTER LLC | 593106055 - (FL) RIVERSIDE PARK SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $594.00 | 1922070911 - FAYETTEVILLE ASC LLC, NORTH HILLS GASTROENTEROLOGY ENDOSCOPY CENTER | 621691451 - (AR) FAYETTEVILLE ASC LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50236 | $494.00 | 1982788220 - CASCADE REGIONAL EYE CENTER INC PS, THE HARMAN EYE CLINIC ASC | 911719913 - SIGHT PARTNERS, LLC | WA | 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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