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CPT 50630 Fee Schedule

Last Verified: November 2025

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.

Ureterolithotomy Lower 1/3
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Urinary System

Common Place of Service

21 - Inpatient Hospital

11 - Office

20 - Urgent Care Facility

Common Modifiers

None

51 - Multiple procedures

RT - Right side of body

Complexity LevelHigh
CMS$865.27 Physician Fee Schedule

National average reimbursement for CPT 50630 by major payers:

bcbs

$1,197.48

uhc

$1,200.30

aetna

$1,227.98

cigna

$1,487.64

Preview provider-level rates for...
For billing codeCPT 50630
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 50630

United
50630$1862.001881678662 - SURGERY AFFILIATE OF EL PASO, LLC, FOUNDATION SURGERY AFFILIATE OF EL PASO, LLC742797719 - (TX) SURGERY AFFILIATE OF EL PASO LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$360.001497895676 - DEKALB GASTROENTEROLOGY ASSOCIATES III, LLC, DEKALB ENDOSCOPY CENTER582316075 - (GA) DEKALB GASTROENTEROLOGY ASSOCIATES III LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$1306.001942397104 - PREMIER ENDOSCOPY, LLC50599351 - (NJ) PREMIER ENDOSCOPY LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$318.001093993727 - CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER261708694 - (NC) CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTERNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$448.001265435176 - POCONO AMBULATORY SURGERY CENTER LTD232611442 - (PA) POCONO AMBULATORY SURGERY CENTER LTDPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$867.001912600826 - SURGICAL CENTER OF TVH882585662 - (ID) SURGICAL CENTER OF TVHIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$100.001902958226 - AMBULATORY SURGERY CENTER OF TUCSON, INC.262420656 - (AZ) AMBULATORY SURGERY CENTER OF TUCSON INCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$725.001598412256 - GEORGIA UROLOGY, PA550846177GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$1064.001588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$300.001093778052 - MIDWEST EYE CONSULTANTS, P.C., CLI SURGERY CENTER351845786 - (IN) MIDWEST EYE CONSULTANTS, P.C.INAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$492.001871260224 - BARNET DULANEY PERKINS EYE CENTER, PC, VALLEY OUTPATIENT SURGERY CENTER562589722 - BARNET DULANEY PERKINS EYE CENTER PLLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$1955.001639146541 - CENTENNIAL ASC, LLC, BAYLOR SURGICARE AT CENTENNIAL352199232 - (TX) CENTENNIAL ASC LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$200.001831182799 - ZION EYE INSTITUTE, INC841432944 - (UT) ZION EYE INSTITUTE INCUTAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$422.001144482753 - CLARKSVILLE EYE SURGERY CENTER261815638 - (TN) CLARKSVILLE EYE SURGERY CENTERTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
50630$431.001124777321 - VIRGINIA CARDIOVASCULAR SPECIALISTS, VCS HEART AND VASCULAR CENTER541090122 - (VA) VIRGINIA CARDIOVASCULAR SPECIALISTS PCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 50630 vs. Other Surgical Procedures on the Urinary System Codes

The CPT 50630 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 50630 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.

CodeComplexityDescription
50605-CPTHighUreterotmy-Insert Indwelling Stent
50610-CPTHighUreterolithotomy Upper 1/3
50620-CPTHighUreterolithotomy;Middle 1/3-Ureter
50630-CPTHighUreterolithotomy Lower 1/3

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 50630 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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