CPT 50955 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 50955 |
National average reimbursement for CPT 50955 by major payers:
$600.76
$603.80
$599.18
$720.67
| 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 50955 | ||||||
United | 50955 | $1925.00 | 1770072803 - PACIFIC VASCUCARE SURGERY CENTER | 823288521 - (CA) PACIFIC VASCUCARE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1400.00 | 1114924651 - CARILION SURGERY CENTER NEW RIVER VALLEY, LLC, CARILION | 800091329 - (VA) CARILION SURGERY CENTER NEW RIVER VALLEY, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $720.00 | 1184897472 - LAKE COUNTRY ENDOSCOPY CENTER, LLC | 261572986 - (WI) LAKE COUNTRY ENDOSCOPY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $2064.00 | 1457682841 - PAIN CARE OF NORTH TEXAS | 200081985 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $2859.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $941.00 | 1295708964 - COLUMBIA TN ENDOSCOPY ASC LLC, MID-SOUTH ENDOSCOPY CENTER | 810558898 - (TN) COLUMBIA TN ENDOSCOPY ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $2307.00 | 1245427228 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1514.00 | 1467629147 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $2388.00 | 1861905176 - BERKSHIRE EYE, LLC | 352609003 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1150.00 | 1053388223 - THE OCULAR SURGERY CENTER, LLC | 742462970 - (TX) THE OCULAR SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1045.00 | 1659594307 - EYE SURGERY CENTER OF NORTHERN NEVADA, LLC | 205368967 - (NV) EYE SURGERY CENTER OF NORTHERN NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $776.00 | 1396738936 - WARREN GASTRO ENDOSCOPY CTR INC | 341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $610.00 | 1386615912 - PUGET SOUND GASTROENTEROLOGY, PLLC, FREMONT ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1050.00 | 1659679074 - EYE SURGERY CENTER OF MIDDLE TENNESSEE, LLC | 275124581 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $3500.00 | 1184689010 - PARK CITIES SURGERY CENTER, LLC, PARK CITIES SURGERY CENTER | 562357079 - (TX) PARK CITIES SURGERY CENTER LLC | TX | 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 50955 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50955 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 50955 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 |
|---|---|---|
| 50951-CPT | Moderate | Ureteral Endoscopy Through Established Ureterostomy, With Or Without Irrigation, Instillation, Or Uretero-Pyelography, Exclusive Of Radiologic Service; |
| 50953-CPT | Moderate | Ureteral Endoscopy Through Established Ureterostomy, With Or Without Irrigation, Instillation, Or Ureteropyelography, Exclusive Of Radiologic Service; With Ureteral Catheterization, With Or Without Dilation Of Ureter |
| 50955-CPT | Moderate | Ureteral Endoscopy Through Established Ureterostomy, With Or Without Irrigation, Instillation, Or Uretero-Pyelography, Exclusive Of Radiologic Service; With Biopsy |
| 50957-CPT | Moderate | Ureteral Endoscopy Through Established Ureterostomy, 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 50955. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50955 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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