CPT 51575 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 80 - Assistant surgeon • AG - Primary physician |
| Complexity Level | High |
| CMS | $1,750.92 Physician Fee Schedule |
National average reimbursement for CPT 51575 by major payers:
$2,282.50
$2,451.65
$2,504.15
$3,021.76
| 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 51575 | ||||||
United | 51575 | $399.00 | 1447212535 - REYNOLDS ROAD SURGICAL CENTER LTD, WILDWOOD SURGICAL CENTER | 311569454 - (OH) REYNOLDS ROAD SURGICAL CENTER DBA WILDWOOD SURGICAL CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $900.00 | 1033195912 - SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC, AVERA ENDOSCOPY/SURGICAL CENTER | 460461429 - (SD) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $558.00 | 1811168164 - UROLOGIC SPECIALISTS OF NEW ENGLAND LLC | 208951188 - (RI) UROLOGIC SPECIALISTS OF NEW ENGLAND, LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $296.00 | 1710952130 - MARYLAND ENDOSCOPY CENTER LLC, MARYLAND ENDOSCOPY CENTER | 521888989 - (MD) MARYLAND ENDOSCOPY CENTER, LLC. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $468.00 | 1922075969 - SAINT MARY'S AMBULATORY SURGERY | 550837980 - (NJ) SAINT MARYS AMBULATORY SURGERY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $426.00 | 1962609560 - FRONT RANGE ENDOSCOPY CENTERS, LLC | 205008349 - (CO) FRONT RANGE ENDOSCOPY CENTERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $734.00 | 1366868572 - PREMIER SURGERY CENTER, LLC | 463321793 - (NC) PREMIER SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $1010.00 | 1174197990 - KANSAS CITY SURGERY CENTER, LLC | 853624014 - (KS) KANSAS CITY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $2407.00 | 1003103474 - NEW ALBANY SURGERY CENTER, LLC | 451617821 - (OH) NEW ALBANY SURGERY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $424.00 | 1942483433 - PREMIER PHYSICIANS CENTERS, INC | 341783789 - (OH) PREMIER PHYSICIANS CENTERS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $904.00 | 1528762671 - BOULEVARD ENT SURGERY CENTER LLC | 921460644 - (TN) BOULEVARD ENT SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $7768.00 | 1740562677 - LOWCOUNTRY SURGERY CENTER LLC, ROPER ST FRANCIS EYE CENTER | 581693021 - (SC) LOWCOUNTRY SURGERY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $840.00 | 1811546575 - FIRST COAST ORTHOPEDIC CENTER, LLC, FIRST COAST SURGERY CENTER | 822929226 - (FL) FIRST COAST ORTHOPEDIC CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $164.00 | 1073713004 - ADVANCED EYE SURGERY CENTER | 205045500 - (CA) ADVANCED EYE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51575 | $550.00 | 1588224802 - FLOWOOD SURGERY CENTER LLC | 842131306 - (MS) FLOWOOD SURGERY CENTER LLC | MS | 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 51575 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51575 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 51575 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 |
|---|---|---|
| 51570-CPT | High | Cystectomy Total |
| 51575-CPT | High | Cystectomy Total W Bil Lymphadenect |
| 51580-CPT | High | Cystectomy,Complete,Ureterosigmoid/-Cuta |
| 51585-CPT | High | Cystectomy, Complete, With Ureterosigmoidostomy Or Ureterocutaneous Transplantations; With Bilateral Pelvic Lymphadenectomy, Including External Iliac, Hypogastric, And Obturator Nodes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51575. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51575 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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