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See a sample rate comparisonCPT 51101 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 Trocar/Cath
| 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 |
| Medicare Fee Schedule | View Medicare rates for 51101 |
| Medicaid Fee Schedule | View Medicaid rates for 51101 |
National average reimbursement for CPT 51101 by major payers:
$173.02
$179.59
$197.53
$109.87
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CPT 51101
5 of 25 sample ratesHigher to lower in this preview
The Western Pennsylvania Hospital, Forbes Regional Campus
Highmark Health
$2,929.87Published rateTexas Orthopedics Surgery Center, LLC, Texas Orthopedics Surgery Center Limited Partnership, Ll
Texas Orthopedics Surgery Center LLC
$1,258.00Published ratePolaris Center For Outpatient Spine Surgery
$750.00Published rateProgressive Surgical Institute Inc.
Progressive Surgical Institute Inc
$487.00Published rateAmy Sullivan
Deaconess Hospital Inc
$107.23Published rate
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See a sample payer proposalCPT 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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