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See a sample rate comparisonCPT 50405 Fee Schedule
Last Verified: October 2026
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.
Revision Of Kidney Ureter, Pyeloplasty Foley Y Pyeloplasty Plastic Operation On Renal Pelvis With Or Without Plastic Operation On Ureter Nephropexy Nephrostomy Pyelostomy Or Ureteral Splinting Complicated Congenital Kidney Abnormality Secondary Pyeloplasty Solitary Kidney Calycoplasty
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50405 |
| Medicaid Fee Schedule | View Medicaid rates for 50405 |
National average reimbursement for CPT 50405 by major payers:
$1,707.96
$1,879.36
$1,999.55
$2,271.53
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CPT 50405
5 of 25 sample ratesHigher to lower in this preview
Carolina Regional Surgery Center. Ltd
Carolina Regional Surgery Center Ltd
$7,402.00Published ratePhoenix Orthopaedic Ambulatory Center, LLC, Gateway Surgery Center
Phoenix Orthopaedic Ambulatory Center, LLC
$2,799.00Published rateDialysis Access Center Of Cincinnati, Inc.
Dialysis Access Center Of Cincinnati Inc
$1,750.00Published rateVirginia Surgery Center, LLC, Cvp Surgery Center
Virginia Surgery Center LLC
$1,248.00Published rateLaser Surgery Holding Company, Ltd
Laser Surgery Holding Company Lt
$561.00Published rate
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See a sample payer proposalCPT 50405 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50405 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 50405 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 |
|---|---|---|
| 50405-CPT | High | Revision Of Kidney Ureter, Pyeloplasty Foley Y Pyeloplasty Plastic Operation On Renal Pelvis With Or Without Plastic Operation On Ureter Nephropexy Nephrostomy Pyelostomy Or Ureteral Splinting Complicated Congenital Kidney Abnormality Secondary Pyeloplasty Solitary Kidney Calycoplasty |
| 50430-CPT | Moderate | Inje Proc For Antegrad Nphrostogrm/Ureterogrmcomplnew Access, Injection Procedure For Antegrade Nephrostogram And/Or Ureterogramcomplete Diagnostic Procedure Including Imaging Guidance (Egultrasound And/Or Floouroscopy) And All Associated Radiological Supervision And Interpretation; New Access |
| 50432-CPT | Moderate | Plmt Nephrostomy Catheter, Placement Of Nephrostomy Catheter Percutaneous Including Diagnostic Nephrostogram And Or Ureterogram When Performed Imaging Guidance Eg Ultrasound And Or Fluoroscopy And All Associated Radiological Supervision And Interpretation |
| 50540-CPT | High | Symphysiotomy For Horseshoe Ki, Symphysiotomy For Horseshoe Kidney With Or Withoutpyeloplasty Andor Other Plastic Procedure Unilateral Or Bilateral (One Operation) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50405. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50405 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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