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See a sample rate comparisonCPT 50431 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Inje Proc For Antegrad Nphrostogrm/Ureterogrmcompl Exist 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; Existing Access
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 50431 |
| Medicaid Fee Schedule | View Medicaid rates for 50431 |
National average reimbursement for CPT 50431 by major payers:
$289.05
$286.96
$384.78
$140.83
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CPT 50431
5 of 25 sample ratesHigher to lower in this preview
Childrens National Medical Center
Childrens Hospital
$700.36Published rateJohn Weinhold
Samaritan Hospital
$427.76Published ratePatricia Wright
Town Center Orthopaedic Associates, P.C.
$335.80Published rateGregg Bean
$233.16Published rateMiaoying Zhang
M Zhang Md LLC
$53.84Published rate
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See a sample payer proposalCPT 50431 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50431 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 50431 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 |
|---|---|---|
| 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 |
| 50431-CPT | Moderate | Inje Proc For Antegrad Nphrostogrm/Ureterogrmcompl Exist 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; Existing 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 |
| 50435-CPT | Moderate | Replace Catheter, Surgery To Insert A Small Flexible Tube (Catheter) Through The Thigh Into The Kidney To Drain Urine. This Is Generally Done In Preparation For A Procedure On The Kidneys Bladder Or Ureter (Tube That Normally Carries Urine From The Kidney To The Bladder). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50431. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50431 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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