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 |
| CMS | $417.59 Physician Fee Schedule |
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 | $2388.00 | 1326142878 - LEBANON ENDOSCOPY CENTER LLC, LEBANON ENDOSCOPY CENTER | 205449574 - (TN) LEBANON ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $2000.00 | 1992259337 - ADVOCATE CONDELL AMBULATORY SURGERY CENTER, LLC | 475337115 - (IL) ADVOCATE CONDELL AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $3099.00 | 1669415451 - BOUNTIFUL SURGERY CENTER LLC | 364581088 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1345.00 | 1922597517 - WGUASC, LLC | 824397113 - (GA) WGUASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $907.00 | 1730124561 - SURGERY CENTER OF WESTON LLC | 650933685 - (FL) SURGERY CENTER OF WESTON LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1526.00 | 1083946149 - METHODIST ENDOSCOPY CENTER LLC | 263765679 - (NE) METHODIST ENDOSCOPY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1555.00 | 1659657856 - ALFA SURGERY CENTER, LLC | 452748642 - (CA) ALFA SURGERY CENTER, LLC | CA | 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 | $4041.00 | 1386165504 - THE EMORY CLINIC INC, EMORY AMBULATORY SURGERY CENTER AT SPIVEY STATION | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1127.00 | 1447457403 - BERGEN GASTROENTEROLOGY PC | 222713168 - (NJ) BERGEN GASTROENTEROLOGY, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $975.00 | 1417142084 - MID- AMERICA SURGERY CENTER, LLC | 204494200 - (MO) MID AMERICA SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $2388.00 | 1861905176 - BERKSHIRE EYE, LLC | 352609003 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1700.00 | 1790736502 - SEVEN HILLS SURGERY CENTER, LLC | 203044042 - SEVEN HILLS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $2100.00 | 1225308257 - CROWN VALLEY OUTPATIENT SURGICAL CENTER LLC, MISSION ENDOSCOPY CENTER | 454125214 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50955 | $1641.00 | 1760414056 - VAN DYCK ASC, LLC | 621817203 - (TN) VAN DYCK ASC LLC | TN | 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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