CPT 50820 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • 51 - Multiple procedures |
| Complexity Level | High |
| CMS | $1,270.89 Physician Fee Schedule |
National average reimbursement for CPT 50820 by major payers:
$1,789.99
$1,768.14
$1,895.62
$2,186.74
| 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 50820 | ||||||
United | 50820 | $565.00 | 1649791641 - NORTHEAST ATLANTA VASCULAR CARE, LLC | 453857751 - (GA) NORTHEAST ATLANTA VASCULAR CARE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $371.00 | 1891295275 - FRESENIUS VASCULAR CARE MONTGOMERY ASC LLC | 815391782 - (AL) FRESENIUS VASCULAR CARE MONTGOMERY ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $1049.00 | 1699284018 - ONYX & PEARL SURGICAL SUITES LLC | 821183739 - (OH) ONYX & PEARL SURGICAL SUITES, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $1306.00 | 1831275775 - NORTH JERSEY GASTROENTEROLOGY & ENDOSCOPY CENTER P.A. | 223637494 - (NJ) NORTH JERSEY GASTROENTEROLOGY ENDOSCOPY CENTER PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $584.00 | 1104272780 - ENT OF SOUTH GEORGIA SURGERY CENTER LLC | 474050916 - (GA) ENT OF SOUTH GEORGIA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $200.00 | 1063819860 - TYLER ASC, LP, TYLER CARDIAC & ENDOVASCULAR SURGERY CENTER | 471418553 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $815.00 | 1912362955 - ST CHARLES SURGICAL CENTER | 474573964 - (CA) ST CHARLES SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $1955.00 | 1609870336 - DESOTO SURGICARE PARTNERS, LTD, NORTH TEXAS SURGERY CENTER | 752592508 - (TX) DESOTO SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $505.00 | 1841222353 - DAY-OP CENTER OF LONG ISLAND LLC, DAY-OP CENTER OF LONG ISLAND | 112811353 - (NY) DAY OP CENTER OF LONG ISLAND INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $2172.00 | 1780683490 - METROCREST SURGERY CENTER LP, BAYLOR SURGICARE AT CARROLLTON | 30380493 - (TX) METROCREST SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $775.00 | 1528462819 - THE ENDOSCOPY CENTER, INC. | 471907162 - (CA) THE ENDOSCOPY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $836.00 | 1558363549 - SUSQUEHANNA VALLEY SURGERY CENTER | 251847818 - (PA) SUSQUEHANNA VALLEY SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $1224.00 | 1659953636 - VCU HEALTH AMBULATORY SURGERY CENTER, LLC | 863310585 - (VA) VCU HEALTH AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $1966.00 | 1649827973 - PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET SAME DAY SURGERY CENTER | 410132080 - (MN) PARK NICOLLET HEALTH SERVICES | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50820 | $637.00 | 1295720530 - ELMIRA ASC LLC | 161549510 - (NY) ELMIRA ASC LLC | NY | 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 50820 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50820 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 50820 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 |
|---|---|---|
| 50820-CPT | High | Ureteroileal Conduit Unilateral |
| 50825-CPT | High | Continent Diversion, Including Intestine Anastomosis Using Any Segment Of Small And/Or Large Intestine (Kock Pouch Or Camey Enterocystoplasty) |
| 50830-CPT | High | Urinary Undiversion (Eg, Taking Down Of Ureteroileal Conduit, Ureterosigmoidostomy Or Ureteroenterostomy With Ureteroureterostomy Or Ureteroneocystostomy) |
| 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 50820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50820 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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