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CPT 51065 Fee Schedule

Last Verified: January 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.

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
Medicare Fee ScheduleView Medicare rates for 51065

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$2903.001144283292 - LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP943419282 - (LA) LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIPLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$830.001730153073 - EAST MEMPHIS UROLOGY CENTER, LP, UROCENTER621810940 - (TN) EAST MEMPHIS UROLOGY CENTER LPTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$8007.001114168309 - MEMORIAL CARE SURGICAL CENTER AT ORANGE COAST, LLC261394069 - (CA) MEMORIAL CARE SURGICAL CENTER AT ORANGE COAST LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$2025.001407812860 - THE SURGICAL CENTER OF THE TREASURE COAST, LLC371446353 - (FL) SURGICAL CENTER OF THE TREASURE COASTFLAmbulatory 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$580.001265442537 - BRIGHTON SURGERY CENTER, LLC743060570 - (NY) BRIGHTON SURGERY CENTER, LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$8705.001306163431 - ROC SURGERY LLC, RILEY OUTPATIENT SURGERY CENTER271497960 - (IN) ROC SURGERY LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1015.001063416998 - WILMINGTON SURGERY CENTER, LP, WILMINGTON SURGCARE621775670 - (NC) WILMINGTON SURGERY CENTER LPNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1550.001356798854 - MID CITIES ASC, LP811663790TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1915.001013471754 - ADVANCED SURGERY CENTER OF LANCASTER, LLC831133719 - (PA) ADVANCED SURGERY CENTER OF LANCASTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1100.001932212511 - PALESTINE LASER & SURGERY CENTER PLLC470900270 - (TX) PALESTINE LASER SURGERY CENTER PLLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$2717.001932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER223777533 - (NJ) MAY STREET SURGI CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1237.001114990231 - SURGERY CENTER OF MIDDLE TENNESSEE LLC, THE SURGERY CENTER OF MIDDLE TENNESSEE621839266 - (TN) SURGERY CENTER OF MIDDLE TENNESSEE LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$1854.001578142352 - CHELMSFORD SURGERY CENTER LLC854172372 - (MA) CHELMSFORD SURGERY CENTER LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51065$2564.001891745956 - NORTH SUBURBAN SPINE CENTER LP, NORTH METRO SURGERY CENTER571231282COAmbulatory 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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