CPT 50974 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 • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| CMS | $452.85 Physician Fee Schedule |
National average reimbursement for CPT 50974 by major payers:
$684.92
$640.34
$651.07
$786.55
| 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 50974 | ||||||
United | 50974 | $794.00 | 1750331435 - EYE HEALTH ASSOCIATES INC | 161583927 - (NY) EYE HEALTH ASSOCIATES INCORPORAT | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $1179.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $1025.00 | 1538389812 - IRONBOUND ENDO SURGICAL CENTER, INC. | 223651393 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $598.00 | 1023153160 - INNOVIA SURGERY CENTER, LLC, ADVANTAGE HEALTHCARE | 364167589 - (IL) INNOVIA SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $1276.00 | 1992992994 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $462.00 | 1427078930 - RETINA CONSULTANTS SURGERY CENTER | 223314785 - (NJ) RETINA CONSULTANTS SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $2575.00 | 1154785848 - PROSPECT CCMC, LLC | 811507712 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $1258.00 | 1144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA | 871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $624.00 | 1598797714 - SURGERY CENTER OF LYNCHBURG LLC | 541935354 - (VA) SURGERY CENTER OF LYNCHBURG LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $932.00 | 1427028919 - CASCADE ENDOSCOPY CENTER, LLC, CASCADE ENDOSCOPY CENTER | 931331197 - (OR) CASCADE ENDOSCOPY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $535.00 | 1154554160 - CABRILLO SURGERY CENTER | 270666008 - (CA) CABRILLO SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $1233.00 | 1295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $615.00 | 1316290380 - ATHENS SURGERY CENTER LLC, THE SURGERY CENTER OF ATHENS | 800812776 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $1367.00 | 1295775369 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE EDMONDS CENTER FOR OUTPATIENT SURGERY | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 50974 | $800.00 | 1033154851 - PARKWEST SURGERY CENTER LP | 621808841 - (TN) PARKWEST SURGERY CENTER LP | 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 50974 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 50974 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 50974 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 50974. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 50974 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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