CPT 50970 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • GC - Service performed by resident under supervision • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| CMS | $355.17 Physician Fee Schedule |
National average reimbursement for CPT 50970 by major payers:
$506.83
$502.29
$510.53
$616.13
| 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 50970 | ||||||
United | 50970 | $1955.00 | 1073694550 - ROCKWALL AMBULATORY SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - ROCKWALL | 205506447 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $300.00 | 1619940582 - FT MYERS DIGESTIVE HEALTH AND PAIN ASC LLC, CENTER FOR DIGESTIVE HEALTH AND PAIN MANAGEMENT | 621848758 - (FL) FT MYERS DIGESTIVE HEALTH AND PAIN ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $850.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $671.00 | 1174590434 - HARMONY SURGERY CENTER, LLC, HARMONY AMBULATORY SURGERY CENTER, LLC | 841479751 - (CO) HARMONY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $326.00 | 1841290103 - CENTRAL FLORIDA EYE INSTITUTE PL | 421621290 - (FL) CENTRAL FLORIDA EYE INSTITUTE PL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $1411.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $426.00 | 1689149601 - ATLANTA PREMIER FOOT AND ANKLE SURGERY | 825318197 - (GA) ATLANTA PREMIER FOOT AND ANKLE SURGERY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $266.00 | 1255347050 - MARYLAND EYE SURGERY CENTER, L.L.C., THE SURGERY CENTER | 522205280 - (MD) MARYLAND EYE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $1708.00 | 1861913220 - SJV MANAGEMENT, LLC, SOUTH JERSEY VASCULAR SURGERY CENTER | 202273476 - (NJ) SJV MANAGEMENT, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $304.00 | 1508986621 - ASHLAND SURGERY CENTER | 830346584 - (OR) ASHLAND SURGERY CENTER INC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $723.00 | 1578515367 - BLACK CANYON SURGICAL CENTER, LLC | 510514274 - (CO) BLACK CANYON SURGICAL CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $1514.00 | 1619245230 - AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | 800768614 - (NJ) AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $447.00 | 1144590332 - HEALTHCARE PARTNERS ASC-LB, LLC, DAVITA MEDICAL ASC | 954628842 - (CA) HEALTHCARE PARTNERS ASCLB LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $893.00 | 1316508252 - MINIMALLY INVASIVE SURGICENTER LLC | 842130499 - (FL) MINIMALLY INVASIVE SURGICENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50970 | $255.00 | 1205221470 - NEWSOM SURGERY CENTER OF SEBRING LLC | 472439597 - (FL) NEWSOM SURGERY CENTER OF SEBRING LLC | FL | 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 50970 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50970 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 50970 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 |
|---|---|---|
| 50961-CPT | Moderate | Ureteral Endoscopy Through Established Ureterostomy, With Or Without Irrigation, Instillation, Or Ureteropyelography, Exclusive Of Radiologic Service; With Removal Of Foreign Body Or Calculus |
| 50970-CPT | Moderate | Ureteral Endoscopy Through Ureterostomy, With Or Without Irrigation, Instillation, Or Uretero-Pyelography, Exclusive Of Radiologic Service; |
| 50972-CPT | Moderate | Ureteral Endoscopy Through Ureterotomy, With Or Without Irrigation, Instillation, Or Ureteropyelography, Exclusive Of Radiologic Service; With Ureteral Catheterization, With Or Without Dilation Of Ureter |
| 50974-CPT | Moderate | Ureteral Endoscopy Through Ureterostomy, With Or Without Irrigation, Instillation, Or Uretero-Pyelography, Exclusive Of Radiologic Service; With Biopsy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 50970. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50970 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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