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See a sample rate comparisonCPT 50961 Fee Schedule
Last Verified: October 2026
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.
Ureter Endoscopy Treatment, Ureteral Endoscopy Through Established Ureterostomy With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service With Removal Of Foreign Body Or Calculus
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 50961 |
| Medicaid Fee Schedule | View Medicaid rates for 50961 |
National average reimbursement for CPT 50961 by major payers:
$507.43
$545.49
$548.80
$537.98
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CPT 50961
5 of 25 sample ratesHigher to lower in this preview
Fairfax Surgical Center, L.P.
Fairfax Surgical Center Lp
$5,002.00Published rateLawrenceville Surgery Center, LLC
Lawrenceville Surgery Center LLC
$1,819.00Published rateUniversity Of Miami, Umiami Medicine - Ophthalmology (Naples Bascom Palmer - Asc)
University Of Miami
$1,314.00Published rateInstitute Of Orthopaedic Surgery LLC
$1,136.00Published rateDonny Le
Deaconess Hospital Inc
$319.08Published rate
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See a sample payer proposalCPT 50961 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50961 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 50961 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 | Urinary Tract Scope Exam, An Exam Of The Upper Portion Of The Urinary Tract. The Procedure Uses A Scope (Endoscope) Inserted Into An Existing Surgical Opening For Draining Urine (Ureterostomy). |
| 50953-CPT | Moderate | Endoscopy Of Ureter, 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 |
| 50957-CPT | Moderate | Ureter Endoscopy Treatment, 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 |
| 50961-CPT | Moderate | Ureter Endoscopy Treatment, Ureteral Endoscopy Through Established Ureterostomy With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service With Removal Of Foreign Body Or Calculus |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50961. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50961 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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