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 |
| CMS | $1,440.07 Physician Fee Schedule |
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 | $6087.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $6492.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $2390.00 | 1710336763 - MT PLEASANT SURGERY CENTER LLC | 300872082 - (MI) MT PLEASANT SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $3530.00 | 1225133994 - VALLEY AMBULATORY SURGICAL CENTER | 203882105 - (PA) VALLEY AMBULATORY SURGICAL CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $5654.00 | 1407981327 - ARIA HEALTH TORRESDALE -SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $2019.00 | 1871593269 - ACADIANA SURGERY CENTER, INC. | 721235496 - (LA) ACADIANA SURGERY CENTER INC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $946.00 | 1871531244 - NORTH HOUSTON ENDOSCOPY & SURGERY | 760688879 - (TX) NORTH HOUSTON ENDOSCOPY SURGERY | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $2754.00 | 1245806876 - WICHITA UROLOGY SURGERY CENTER,LLC | 834482229 - (KS) WICHITA UROLOGY SURGERY CENTERLLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $788.00 | 1366710741 - THE EYE PHYSICIANS OF PINELLAS, PA, LARGO AMBULATORY SURGERY CENTER | 593400241 - (FL) THE EYE PHYSICIANS OF PINELLAS, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $6492.00 | 1356307565 - AMBULATORY SURGICAL ASSOCIATES LLC, TULLAHOMA SURGERY CENTER | 61658016 - (TN) AMBULATORY SURGICAL ASSOCIATES LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $3844.00 | 1639499627 - GEORGIA UROLOGY, PA, GEORGIA UROLOGY ASC MARIETTA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $2788.00 | 1689635757 - ATLANTICARE SURGERY CENTER LLC | 223265214 - ATLANTICARE HEALTH SYSTEM INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50543 | $3400.00 | 1033363064 - TATTNALL HOSPITAL COMPANY, LLC, OPTIM SURGERY CENTER | 300466706 | GA | 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 | $1230.22 | 1093449126 - ROMAN COMER | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
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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