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See a sample rate comparisonCPT 51520 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.
Cystotomy; For Smple Xcision Of Vesical Nck (Sepa Proc), Cystotomy; For Simple Excision Of Vesical Neck (Separate Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures AS - PA/NP/CNS assistant at surgery 82 - Assistant surgeon - no qualified resident LT - Left side of body GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 51520 |
| Medicaid Fee Schedule | View Medicaid rates for 51520 |
National average reimbursement for CPT 51520 by major payers:
$773.89
$799.07
$820.16
$976.00
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CPT 51520
5 of 25 sample ratesHigher to lower in this preview
North State Surgery Centers, Lp, Mercy Surgery Center
$5,124.00Published rateWayne Surgical Center LLC
Wayne Surgical Center, LLC
$2,500.00Published rateCenter For Robotic Surgery Of Louisiana LLC
$1,391.00Published rateAbingdon Surgical Center PC
$1,050.00Published rateTampa Bay Specialty Surgery Center LLC, Tampa Bay Specialty Surgery Center
Tampa Bay Specialty Surgery Center LLC
$504.00Published rate
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See a sample payer proposalCPT 51520 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51520 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 51520 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.
| Code | Complexity | Description |
|---|---|---|
| 51520-CPT | Moderate | Cystotomy; For Smple Xcision Of Vesical Nck (Sepa Proc), Cystotomy; For Simple Excision Of Vesical Neck (Separate Procedure) |
| 51525-CPT | High | Cystotomy; For Xcision Of Bladder Dverticulum Sngle Or Multi, Cystotomy; For Excision Of Bladder Diverticulum Single Or Multiple (S |
| 51530-CPT | Moderate | Cystotomy;For Excis-Bladder Tumor |
| 51550-CPT | High | Cystectomy Partial Simple |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51520 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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