CPT 50434 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50434 |
National average reimbursement for CPT 50434 by major payers:
$1,022.89
$1,201.02
$1,276.26
$1,443.86
| 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 50434 | ||||||
United | 50434 | $1948.31 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 50434 | $1519.32 | 1457572596 - CASANA SIEBERT | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 50434 | $1519.32 | 1013222322 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Pain Medicine Physician (208VP0000X) |
United | 50434 | $1121.41 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 50434 | $6174.33 | 1376520403 - OGUZ AKIN | 593801080 | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 50434 | $1195.50 | 1306391610 - CAMILLA GRANT | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 50434 | $4388.43 | 1366420713 - ERIC LIS | 593801080 | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 50434 | $698.07 | 1801076120 - STEFANIE LANGENBERG | 350593390 - DEACONESS HOSPITAL INC | PA | Certified Registered Nurse Anesthetist (367500000X) |
United | 50434 | $4388.43 | 1619248457 - THOMAS JOHN | 593801080 | NJ | Hospitalist Physician (208M00000X) |
United | 50434 | $2413.55 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 50434 | $1541.83 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 50434 | $4388.43 | 1255545653 - ATIF KHAN | 593801080 | NJ | Radiation Oncology Physician (2085R0001X) |
United | 50434 | $6057.74 | 1780924548 - LIWEI JIANG | 593801080 | NY | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 50434 | $1322.15 | 1548536774 - ASHLEY BOYLE | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 50434 | $955.66 | 1841327384 - MAGDA ERAIBA | 1841327384 - (NJ) MAGDA ERAIBA | NJ | Internal Medicine Physician (207R00000X) |
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 50434 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50434 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 50434 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 |
|---|---|---|
| 50432-CPT | Moderate | 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. |
| 50433-CPT | High | Placement Of Nephroureteral Catheter Percutaneousincluding Diagnostic Nephrostogram And/Or Ureterogram When Performed Imaging Guidance (Eg Ultrasound And/Or Fluoroscopy) And All Associated Radiological Supervision And Interpretation New Access. |
| 50434-CPT | High | Convert Nephrostomy Catheter To Nephroureteral Catheter, Percutaneous, Including Diagnostic Nephrostogram And/Or Ureterogram When Performed, Imaging Guidance (Eg, Ultrasound And/Or Fluoroscopy) And All Associated Radiological Supervision And Interpretation, Via Pre |
| 50435-CPT | Moderate | Exchange 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50434. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50434 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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