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See a sample rate comparisonCPT 50555 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.
Kidney Endoscopy Biopsy, Renal Endoscopy Through Established Nephrostomy Or Pyelostomy With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service With Biopsy
| 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 50555 |
| Medicaid Fee Schedule | View Medicaid rates for 50555 |
National average reimbursement for CPT 50555 by major payers:
$543.13
$576.41
$582.05
$574.91
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CPT 50555
5 of 25 sample ratesHigher to lower in this preview
Shore Ambulatory Surgical Center, LLC
Shore Ambulatory Surgical Center LLC
$2,382.00Published rateFoothills Surgery Center, LLC
$1,290.00Published rateSurgery Center Of Gilbert LLC, Surgery Center Of Gilbert
Surgery Center Of Gilbert, LLC
$989.00Published rateOrtho Central
$575.00Published rateTri-Cities Endoscopy Center PC, The Center For Digestive Wellness
Tricities Endoscopy Center PC
$375.00Published rate
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See a sample payer proposalCPT 50555 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50555 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 50555 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 |
|---|---|---|
| 50551-CPT | Moderate | Renal Endoscopy Through Establ, Renal Endoscopy Through Established Nephrostomy Orpyelostomy With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service |
| 50553-CPT | Moderate | Kidney Endoscopy, Renal Endoscopy Through Established Nephrostomy Or Pyelostomy With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service With Ureteral Catheterization With Or Without Dilation Of Ureter |
| 50555-CPT | Moderate | Kidney Endoscopy Biopsy, Renal Endoscopy Through Established Nephrostomy Or Pyelostomy With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service With Biopsy |
| 50557-CPT | Moderate | Kidney Endoscopy Treatment, Renal Endoscopy Through Established Nephrostomy Or Pyelostomy With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service With Fulguration And Or Incision With Or Without Biopsy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50555. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50555 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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