CPT 51101 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Low |
| CMS | $145.88 Physician Fee Schedule |
National average reimbursement for CPT 51101 by major payers:

$173.02

$179.59

$197.53

$255.08
| 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 51101 | ||||||
United | 51101 | $947.00 | 1922660109 - BANNER SURGERY CENTER | 842157389 - (AZ) BANNER SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $382.00 | 1720125156 - SCOTTSDALE EYE INSTITUTE, PLC, SCOTTSDALE EYE INSTITUTE, PLC | 61692976 - (AZ) SCOTTSDALE EYE INSTITUTE PLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $1132.00 | 1588746333 - TALLAHASSEE ORTHPAEDIC SURGERY PARTNERS LTD | 752535417 - (FL) TALLAHASSEE ORTHPAEDIC SURGERY PARTNERS LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $487.00 | 1568448660 - PROGRESSIVE SURGICAL INSTITUTE INC. | 232973820 - (PA) PROGRESSIVE SURGICAL INSTITUTE INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $707.00 | 1518338052 - CENTER FOR ADVANCED SURGERY LLC | 464112873 - (SC) CENTER FOR ADVANCED SURGERY, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $2392.00 | 1538104724 - FORT WORTH ENDOSCOPY CENTERS, LLC, SOUTHWEST FORT WORTH ENDOSCOPY CENTER | 770368346 - (TX) FORT WORTH ENDOSCOPY CENTERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $775.00 | 1184378846 - INTREPID LANE ASC, LLC | 851832565 - (NY) INTREPID LANE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $960.00 | 1962455428 - VALLEY EYE INSTITUTE ASC LLC, CVP SURGERY CENTER | 200080762 - (OH) VALLEY EYE INSTITUTE ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $1169.00 | 1780791798 - LINDSAY HOUSE SURGERY CENTER LLC | 320178342 - (NY) LINDSAY HOUSE SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $463.00 | 1336272657 - ARIZONA DIGESTIVE CENTER, P.C. | 201544723 - (AZ) ARIZONA DIGESTIVE CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $725.00 | 1598412256 - GEORGIA UROLOGY, PA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $719.00 | 1255303517 - ST DOMINIC AMBULATORY SURGERY CENTER L L C | 640908713 - (MS) ST DOMINIC AMBULATORY SURGERY CENTER L L C | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $1585.00 | 1659316917 - SUGAR LAND SURGERY CENTER LTD | 621742196 - (TX) SUGAR LAND SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $536.00 | 1023266145 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51101 | $1955.00 | 1962681130 - BAYLOR SURGICARE AT PLANO, LLC, BAYLOR SCOTT & WHITE SURGICARE - PLANO | 260308454 | TX | 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 51101 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51101 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 51101 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 51101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51101 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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