CPT 51595 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 • 22 - Increased Procedural Services • GC - Service performed by resident under supervision |
| Complexity Level | High |
| CMS | $2,106.40 Physician Fee Schedule |
National average reimbursement for CPT 51595 by major payers:
$2,796.40
$2,948.99
$3,184.67
$3,636.45
| 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 51595 | ||||||
United | 51595 | $661.00 | 1336254770 - EYE SURGERY CENTER OF THE DESERT | 330708059 - (CA) EYE SURGERY CENTER OF THE DESERT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $2785.00 | 1710940218 - DENVER MID-TOWN SURGERY CENTER LTD | 752548180 - DENVER MIDTOWN SURGERY CENTER LTD | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $477.00 | 1831109875 - M-S SURGERY CENTER LLC | 205219388 - (CA) MS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $675.00 | 1932496908 - CONCOURSE DIAGNOSTIC SURGERY CENTER, LLC, CONCOURSE DIAGNOSTIC SURGERY CENTER,LLC | 273205326 - (CA) CONCOURSE DIAGNOSTIC & SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $640.00 | 1013417351 - BURNSIDE SURGERY CENTER LLC | 821290460 - (OR) BURNSIDE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $4115.00 | 1205892197 - ALASKA SURGERY CENTER, LIMITED PARTNERSHIP | 930982396 - (AK) ALASKA SURGERY CENTER LIMITED PARTNERSHIP | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $369.00 | 1760447015 - SHEA CLINIC, SHEA CLINIC, ASC | 620673817 - (TN) SHEA CLINIC CORPORATION | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $1064.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $1049.00 | 1063092047 - TAMPA BAY JOINT AND SPINE, LLC, TAMPA BAY JOINT AND SPINE SURGERY CENTER | 851259146 - (FL) TAMPA BAY JOINT AND SPINE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $258.00 | 1518300102 - SPRINGFIELD SURGERY CENTER, LLC | 461041413 - (NJ) SPRINGFIELD SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $220.00 | 1649494170 - SOUTHWEST ENDOSCOPY AND SURGERY CENTER | 203136303 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $1127.00 | 1427471911 - NORTHWOODS SURGERY CENTER LLC | 462454295 - (MN) NORTHWOODS SURGERY CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $475.00 | 1699286922 - HUMBLE VASCULAR SURGICAL CENTER LLC | 820905971 - (TX) HUMBLE VASCULAR SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $541.00 | 1922187103 - NORTH HILLS SURGERY CENTER, LLC, NORTH HILLS SURGERY CENTER | 710807771 - (AR) NORTH HILLS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51595 | $983.00 | 1851710735 - SURGCENTER TUCSON, LLC | 462350774 - (AZ) SURGCENTER TUCSON, LLC | AZ | 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 51595 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51595 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 51595 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 |
|---|---|---|
| 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 |
| 51590-CPT | High | Cystectomy,Compl,W Conduit/Bladder,W Bow |
| 51595-CPT | High | Cystectomy, Complete, With Ureteroileal Conduit Or Sigmoid Bladder, Including Intestine Anastomosis; 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 51595. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51595 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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