CPT 50385 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 | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| CMS | $939.34 Physician Fee Schedule |
National average reimbursement for CPT 50385 by major payers:
$1,243.99
$1,505.11
$1,469.26
$1,706.64
| 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 50385 | ||||||
United | 50385 | $960.00 | 1023551413 - MID-BRONX ENDOSCOPY CENTER LLC | 471156630 - (NY) MIDBRONX ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $811.00 | 1811932270 - PHILADELPHIA SURGI CENTER, INC. | 232965126 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $1100.00 | 1306135298 - DMG PAIN MANAGEMENT SURGERY CENTER, LLC | 271322187 - (IL) DMG PAIN MANAGEMENT SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $2353.00 | 1366515504 - RIVERSIDE AMBULATORY SURGERY CENTER, LLC, THE ENDOSCOPY & COLONOSCOPY CENTER | 205227186 - (MO) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $2499.00 | 1083754352 - MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA, MERCY PHILADELPHIA HOSPITAL SHORT PROCEDURE UNIT | 231352191 - (PA) MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $1150.00 | 1528206141 - HATTIESBURG EYE CLINIC CATARACT & LASIK SURGERY CENTER, LLC | 200379151 - (MS) HATTIESBURG EYE CLINIC CATARACT LASIK SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $984.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $1175.00 | 1952535502 - PLATEAU SURGERY CENTER | 264769256 - (TN) PLATEAU SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $614.00 | 1326563537 - OPTUMCARE COLORADO ASC, LLC | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $638.00 | 1942485305 - 9106 PHILADELPHIA ROAD AMBULATORY SURGERY CENTER LLC | 261539834 - (MD) 9106 PHILADELPHIA ROAD AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $889.00 | 1184627978 - NOVAMED SURGERY CENTER OF ORLANDO LLC, DOWNTOWN SURGERY CENTER | 522441418 - (FL) NOVAMED SURGERY CENTER OF ORLANDO LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $950.00 | 1497029466 - MOUNTAIN HOME SURGERY CENTER, INC. | 454157268 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $2307.00 | 1790104248 - METRO SURGERY CENTER, LLC, METRO SURGERY CENTER, LP | 810587498 - (AZ) METRO SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $1400.00 | 1114924651 - CARILION SURGERY CENTER NEW RIVER VALLEY, LLC, CARILION | 800091329 - (VA) CARILION SURGERY CENTER NEW RIVER VALLEY, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50385 | $1036.00 | 1700967106 - EBSC, LLC, SURGICAL CARE CENTER OF MICHIGAN | 382840421 - (MI) EBSC LLC | 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 50385 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50385 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 50385 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 |
|---|---|---|
| 50382-CPT | High | Removal (Via Snare/Capture) And Replacement Of Internally Dwelling Ureteral Stent Via Percutaneous Approach, Including Radiological Supervision And Interpretation |
| 50384-CPT | High | Removal (Via Snare/Capture) Of Internally Dwelling Ureteral Stent Via Percutaneous Approach, Including Radiological Supervision And Interpretation |
| 50385-CPT | High | Removal (Via Snare/Capture) And Replace Ment Of Internally Dwelling Ureteral Stent Via Transurethral Approach Without Use Of Cystoscopy Including Radiological Supervision And Inter Pretation |
| 50386-CPT | Moderate | Removal (Via Snare/Capture) Of Internally Dwelling Ureteral Stent Via Transurethral Approach Without Use Of Cystoscopy Including Radiological Supervision And Interpretation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50385. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50385 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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