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CPT 51065 Fee Schedule

Last Verified: November 2025

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.

Cystotomy W Extract/Fragm Uret Calc
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Urinary System

Common Place of Service

22 - On Campus Outpatient Hospital

21 - Inpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

62 - Co-Surgeons

AS - PA/NP/CNS assistant at surgery

22 - Increased Procedural Services

51 - Multiple procedures

Complexity LevelModerate
CMS$567.03 Physician Fee Schedule

National average reimbursement for CPT 51065 by major payers:

bcbs

$778.86

uhc

$776.73

aetna

$792.22

cigna

$971.05

Preview provider-level rates for...
For billing codeCPT 51065
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 51065

United
51065$1871.001861487324 - DOCTORS PARK SURGERY INC431608281 - (MO) DOCTORS PARK SURGERY, INCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1500.001700389822 - CENTER FOR SPINE INTERVENTIONS ASC 2813634134GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$505.001790902617 - WEST WICHITA FAMILY PHYSICIANS, P.A., WEST WICHITA SURGERY CENTER742848808 - (KS) WEST WICHITA FAMILY PHYSICIANS, P.A.KSAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1847.001619979580 - PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER PORT ORANGE201388947FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1005.001083920151 - HILLMOOR EYE SURGERY CENTER, LLC, ONE DAY SURGERY273127763 - (FL) HILLMOOR EYE SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$911.001851342430 - BEL AIR AMBULATORY SURGICAL CENTER ,L.L.C.522125649 - (MD) BEL AIR AMBULATORY SURGICAL CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$4544.001316487093 - NORTH SHORE SURGICAL SUITES, LLC, NORTH SHORE SURGICAL SUITES814641285 - (WI) NORTH SHORE SURGICAL SUITES, LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$2859.001518984301 - ENDOSCOPY CENTER OF INLAND EMPIRE INC474733900CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$2046.001669079992 - WOODBURY SURGERY CENTER, LLC853366699 - (MN) WOODBURY SURGERY CENTER LLCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1673.001790798668 - UNIVERSITY HOSPITALS MANAGEMENT SERVICES ORGANIZATION INC, UHHS WESTLAKE SURGERY CENTER341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$2717.001609803204 - AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC, AFFILIATED ENDOSCOPY SERVICES OF CLIFTON270064844 - (NJ) AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1854.001578142352 - CHELMSFORD SURGERY CENTER LLC854172372 - (MA) CHELMSFORD SURGERY CENTER LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1751.001518300102 - SPRINGFIELD SURGERY CENTER, LLC461041413 - (NJ) SPRINGFIELD SURGERY CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$967.001376092205 - ADVANCED INTERVENTIONAL PAIN SURGERY CENTER LLC812830135 - (AR) ADVANCED INTERVENTIONAL PAIN SURGERY CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$2000.001720434731 - NEW BRAUNFELS SPINE & PAIN SURGERY472062067 - (TX) NEW BRAUNFELS SPINE PAIN SURGERYTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 51065 vs. Other Surgical Procedures on the Urinary System Codes

The CPT 51065 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 51065 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.

CodeComplexityDescription
51050-CPTModerateCystolithotomy Wo Neck Resect
51060-CPTModerateTransvesical Ureterolithotomy
51065-CPTModerateCystotomy W Extract/Fragm Uret Calc
51530-CPTModerateCystotomy;For Excis-Bladder Tumor

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 51065 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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