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See a sample rate comparisonCPT 51100 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.
Drain Bladder By Needle
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room |
| Common Modifiers | None 59 - Distinct Procedural Service 78 - Return to OR - related procedure |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 51100 |
| Medicaid Fee Schedule | View Medicaid rates for 51100 |
National average reimbursement for CPT 51100 by major payers:
$85.31
$87.46
$95.17
$127.54
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CPT 51100
5 of 25 sample ratesHigher to lower in this preview
Bay Area Surgicenter, LLC, Brandon Surgery Center
Bay Area Surgicenter LLC
$2,965.00Published rateBethesda Chevy Chase Surgery Center, LLC
Bethesda Chevy Chase Surgery Cen
$555.00Published rateGeorgia Surgical Center On Peachtree, LLC
Georgia Surgical Center On Peachtree LLC
$277.00Published rateNorthern Plains Surgery Center LLC
Northern Plains Surgery Center, LLC
$125.00Published rateWinter Haven-Sebring Fl Ophthalmology Asc LLC, Eye Surgery & Laser Center Of Sebring
$50.00Published rate
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See a sample payer proposalCPT 51100 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51100 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 51100 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51100 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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