CPT 50694 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 |
| CMS | $1,037.68 Physician Fee Schedule |
National average reimbursement for CPT 50694 by major payers:
$1,334.32
$1,535.69
$1,581.60
$1,804.69
| 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 50694 | ||||||
United | 50694 | $1600.00 | 1447991138 - SILVER STATE SURGERY CENTER WEST LLC | 872764352 - (NV) SILVER STATE SURGERY CENTER WEST LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $1954.46 | 1225476146 - JACKLYN OAKLEY | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 50694 | $995.00 | 1932190170 - OCALA EYE SURGERY CENTER INC | 593323478 - (FL) OCALA EYE SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $898.00 | 1194146787 - CELENA MCCANDLESS | 350593390 - DEACONESS HOSPITAL INC | IN | Physician Assistant (363A00000X) |
United | 50694 | $4426.00 | 1285870303 - LAPORTE MEDICAL GROUP SURGICAL CENTER, LLC | 260505795 - (IN) LAPORTE MEDICAL GROUP SURGICAL CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $5923.00 | 1801854591 - SAN ANTONIO SURGERY CENTER, THE CENTER FOR SPECIAL SURGERY @ TCA | 300796793 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $3347.00 | 1689666596 - MENOMONEE FALLS AMBULATORY SURGERY CENTER, LLC | 391745697 - (WI) MENOMONEE FALLS AMBULATORY SURGERY CENTER | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $1500.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $2407.00 | 1740671429 - TEXOMA SURGERY CENTER LLC | 463836605 - (TX) TEXOMA SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $550.00 | 1750313144 - AMBULATORY SURGICAL CARE, LLC | 593082994 - (FL) AMBULATORY SURGICAL CARE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $3570.00 | 1316947609 - AMARILLO ENDOSCOPY CENTER, LP | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $1954.46 | 1346774536 - AYSHA KHAN | 350593390 - DEACONESS HOSPITAL INC | IL | Internal Medicine Physician (207R00000X) |
United | 50694 | $1936.00 | 1457695116 - SOUND PAIN ALLIANCE, MT. BAKER SURGERY CENTER | 823663428 - SOUND PAIN ALLIANCE | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $480.00 | 1861660151 - HOWERTON SURGICAL CENTER, LLC | 450581270 - (TX) HOWERTON SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50694 | $730.00 | 1649233719 - GI ASC LLC | 861122720 - (PA) GI ASC LLC | PA | 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 50694 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50694 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 50694 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 |
|---|---|---|
| 50693-CPT | High | Placement Of Ureteral Stent Percutaneous Including Diagnostic Nephrostogram And/Or Ureterogram When Performed Imaging Guidance (Eg Ultrasound And/Or Fluoroscopy) And All Associated Radiological Supervision And Interpretation; Pre-Existing Nephrostomy Tract. |
| 50694-CPT | High | Placement Of Ureteral Stent Percutaneous Including Diagnostic Nephrostogram And/Or Ureterogram When Performed Imaging Guidance (Eg Ultrasound And/Or Fluoroscopy) And All Associated Radiological Supervision And Interpretation; New Access Without Separate Nephrostomy Catheter. |
| 50695-CPT | High | Placement Of Ureteral Stent Percutaneous Including Diagnostic Nephrostogram And/Or Ureterogram When Performed Imaging Guidance (Eg Ultrasound And/Or Fluoroscopy) And All Associated Radiological Supervision And Interpretation; New Access With Separate Nephrostomy Catheter. |
| 50947-CPT | High | Laparoscopy; Ureteroneocystostomy W Cystoscopy &Ureteral Stent Placemt |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50694. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50694 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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