CPT 50815 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • SG - Scene to Hospital ESRD facility |
| Complexity Level | High |
| CMS | $1,186.15 Physician Fee Schedule |
National average reimbursement for CPT 50815 by major payers:
$1,709.10
$1,645.41
$1,686.01
$2,041.32
| 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 50815 | ||||||
United | 50815 | $752.00 | 1942265939 - INLAND SURGERY CENTER LP | 330018673 - (CA) INLAND SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $456.00 | 1053319053 - EYE SURGERY CENTER OF NEW ALBANY, LLC, NOVAMED EYE SURGERY CENTER OF NEW ALBANY, LLC | 364148241 - (IN) EYE SURGERY CENTER OF NEW ALBANY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $671.00 | 1295463990 - SHARPEVISION PLLC | 454849447 - (WA) SHARPEVISION, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $517.00 | 1558720235 - DHCH LLC | 811030907 - (NY) DHCH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $2812.00 | 1205869211 - ROANOKE SURGERY CENTER, LP | 61755240 - (VA) ROANOKE SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $750.00 | 1285108845 - MARIETTA ADVANCED SURGERY CENTER | 832382468 - (GA) MARIETTA ADVANCED SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $3028.00 | 1245375369 - BARNES-KASSON COUNTY HOSPITAL | 240798681 - (PA) BARNES-KASSON COUNTY HOSPITAL | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $565.00 | 1053560896 - ASC DEVELOPMENT COMPANY, LLC, NATIONAL SPINE AND PAIN CENTERS | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $670.00 | 1609896539 - CEDAR HILLS AMBULATORY SURGERY CENTER LLC, CEDAR HILLS SURGERY CENTER | 680580628 - (OR) CEDAR HILLS AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $1064.00 | 1275292229 - SCOTTSDALE ENDOSCOPY ASC LLC | 873952617 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $1028.00 | 1194913574 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $17689.00 | 1174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER | 461848055 - (WI) AURORA GI ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $850.00 | 1164584066 - NAPERVILLE SURGICAL CENTRE LLC | 200433367 - (IL) NAPERVILLE SURGICAL CENTRE, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $673.00 | 1235677808 - ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER-LOGANVILLE, LLC | 812389963 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50815 | $1064.00 | 1093085904 - ARIZONA ADVANCED ENDOSCOPY LLC | 453051125 - (AZ) ARIZONA ADVANCED ENDOSCOPY, LLC | AZ | 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 50815 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50815 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 50815 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 |
|---|---|---|
| 50800-CPT | High | Ureteroenterostomy |
| 50810-CPT | High | Ureterosigmoidostomy, With Creation Of Sigmoid Bladder And Establishment Of Abdominal Or Perineal Colostomy, Including Intestine Anastomosis |
| 50815-CPT | High | Ureterocolon Conduit Unilateral |
| 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 50815. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50815 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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