CPT 50543 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 50543 |
National average reimbursement for CPT 50543 by major payers:
$1,910.41
$2,000.91
$2,178.29
$2,479.40
| 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 50543 | ||||||
United | 50543 | $2005.93 | 1033190129 - MAE PHYSICIANS SURGERY CENTER, LLC | 640914895 - (MS) MAE PHYSICIAN'S SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $2210.00 | 1932183266 - SINGLE DAY SURGERY CENTER LLC | 880504513 - (NV) SINGLE DAY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $2963.00 | 1568469328 - WYOMISSING SURGICAL SERVICES INC. | 731647840 - (PA) WYOMISSING SURGICAL SERVICES INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $976.00 | 1912971326 - ADVANCED SURGERY CENTER, LLC | 351991340 - (IN) ADVANCED SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $11291.00 | 1073009304 - SUSITNA SURGERY CENTER LLC | 472934701 - (AK) SUSITNA SURGERY CENTER LLC | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $1230.22 | 1093449126 - ROMAN COMER | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 50543 | $2677.56 | 1659668804 - RAGHAV GUPTA | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 50543 | $2019.00 | 1871593269 - ACADIANA SURGERY CENTER, INC. | 721235496 - (LA) ACADIANA SURGERY CENTER INC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $2300.00 | 1346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP | 593346125 - (FL) LAKELAND SURGICAL AND DIAGNOSTIC CENTER LLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $6365.00 | 1487620043 - NEW HORIZONS SURGERY CENTER LLC | 731572167 - (OH) NEW HORIZONS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $1766.00 | 1417987595 - ENDOSCOPY CENTER OF NORTH BALTIMORE | 412081861 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $6492.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $6492.00 | 1629508387 - WELLINGTON ENDOSCOPY CENTER LLC | 813254698 - (FL) WELLINGTON ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $5484.00 | 1992713010 - NORTHFIELD SURGICAL CENTER LLC, NORTHFIELD SURGICAL CENTER | 223509801 - (NJ) NORTHFIELD SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $6492.00 | 1427003052 - EYE SURGERY CENTER OF NASHVILLE LLC | 621872622 - (TN) EYE SURGERY CENTER OF NASHVILLE LLC | TN | 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 50543 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50543 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 50543 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 | 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, Calyco |
| 50541-CPT | High | Laparoscopy, Surgical; Ablation Of Renal Cysts |
| 50542-CPT | High | Laparoscopy, Surgical; Ablation Of Renal Mass Lesion(S), Including Intraoperative Ultrasound Guidance & Monitoring, When Performed- Rn Review>=6/10/2006 |
| 50543-CPT | High | Laparoscopy, Surgical; Partial Nephrectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50543. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50543 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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