CPT 51585 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 • 11 - Office |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 51585 |
National average reimbursement for CPT 51585 by major payers:
$2,722.82
$2,838.14
$2,922.47
$3,502.78
| 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 51585 | ||||||
United | 51585 | $961.00 | 1043246077 - DUTCHESS AMBULATORY SURGICAL CENTER | 141803011 - (NY) DUTCHESS AMBULATORY SURGICAL CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $3013.00 | 1871575043 - AMBULATORY SURGERY CENTER OF COOL SPRINGS LLC, VANDERBILT SURGERY CENTER COOL SPRINGS | 621809227 - (TN) AMBULATORY SURGERY CENTER OF COOL SPRINGS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $495.00 | 1326340852 - THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC, SURGICAL INSTITUTE OF MONROE | 270843485 - (MI) SURGICAL INSTITUTE OF MONROE | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $5213.00 | 1548844400 - SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | 863451115 - (KS) SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $2517.00 | 1780797910 - CRYSTAL CITIES SURGERY CENTER, TWIN CITIES SURGERY CENTER | 260839397 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $1049.00 | 1558487009 - MIDWEST DIGESTIVE HEALTH CENTER LLC | 431918703 - (MO) MIDWEST DIGESTIVE HEALTH CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $7400.00 | 1669559928 - SENATE STREET SURGERY CENTER LLC, CLARIAN HEALTH PARTNERS INC MBR | 421709357 - (IN) SENATE STREET SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $410.00 | 1831441617 - PLANNED PARENTHOOD OF GREATER TEXAS SURGICAL HEALTH SERVICES | 201121091 - (TX) PLANNED PARENTHOOD OF GREATER TEXAS SURGICAL HEALTH SERVICES | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $194.00 | 1669577524 - SKIN & MOHS SURGERY CENTER, LLC | 431823843 - SKIN MOHS SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $650.00 | 1356814958 - CLEVELAND CHILDRENS SURGERY CENTER LLC | 301128634 - (OH) CLEVELAND CHILDRENS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $500.00 | 1841290103 - CENTRAL FLORIDA EYE INSTITUTE PL | 421621290 - (FL) CENTRAL FLORIDA EYE INSTITUTE PL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $736.00 | 1639498454 - NEW VISTA HEALTH, LLC, PINEY POINT SURGERY CENTER | 272416864 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $1274.00 | 1346237328 - VICTORIA AMBULATORY SURGERY CENTER, LP, THE SURGERY CENTER | 352240144 - (TX) VICTORIA AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $893.00 | 1366456618 - SKYWAY SURGERY CENTER. LLC | 753035490 - (CA) SKYWAY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51585 | $650.00 | 1902864879 - SPOKANE SURGERY CENTER LTD PS | 911336886 - (WA) SPOKANE SURGERY CENTER LTD | WA | 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 51585 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51585 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 51585 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 51585. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51585 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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