CPT 51596 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 22 - Increased Procedural Services • GC - Service performed by resident under supervision |
| Complexity Level | High |
| CMS | $2,275.58 Physician Fee Schedule |
National average reimbursement for CPT 51596 by major payers:
$2,839.49
$3,167.72
$3,384.29
$3,921.24
| 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 51596 | ||||||
United | 51596 | $1114.00 | 1912460015 - PREMIER EYE SURGERY CENTER OF COLORADO, LLC, PREMIER EYE SURGERY CENTER | 823760640 - (CO) PREMIER EYE SURGERY CENTER OF COLORADO, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $1064.00 | 1114926714 - ENDOSCOPY CENTER OF DAYTON LTD | 311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $906.00 | 1659574283 - PROVIDENCE VENTURES, LLC, BONE AND JOINT SURGERY CENTER OF NOVI | 161704029 - (MI) PROVIDENCE VENTURES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $529.00 | 1215522727 - PREMIER 2020, LLC, PREMIER SURGICAL CENTER | 863194124 - (PA) PREMIER 2020 LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $840.00 | 1447457403 - BERGEN GASTROENTEROLOGY PC | 222713168 - (NJ) BERGEN GASTROENTEROLOGY, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $362.00 | 1841459211 - AASC, LLC, ATLANTA AESTHETIC SURGERY CENTER | 352491038 - (GA) SURGERY CENTER OF ATLANTA | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $699.00 | 1538386743 - HOWARD S BARNEBEY MD, SPECIALY EYECARE CENTRE | 911357221 - (WA) SPECIALTY EYE CARE CENTRE | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $100.00 | 1538113238 - ADVANCED LASER & SURGICENTER OF ARIZONA, PC | 721546625 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $1028.00 | 1194351833 - DELRAY BEACH ASC, LLC, DELRAY BEACH SURGERY CENTER | 843067076 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $1477.00 | 1669021283 - EL DORADO SURGERY CENTER LP, TUCSON ENDOSCOPY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $675.00 | 1487198495 - SURGERY CENTER OF NAPLES, LLC | 812002107 - (FL) SURGERY CENTER OF NAPLES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $3320.12 | 1346220373 - HIGH POINT SURGERY CENTER, LLC | 561867005 - (NC) HIGH POINT SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $1064.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $300.00 | 1386652667 - MACON OUTPATIENT SURGERY, LLC | 203027560 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51596 | $739.00 | 1497201867 - ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY, L.L.C. | 813619502 - (TX) ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY LLC | TX | 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 51596 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51596 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 51596 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 |
| 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 |
| 51596-CPT | High | Removal Of Bladder And Lymph Nodes On Both Sides Of Pelvis With Transplantation Of Ureters To Small And/Or Large Bowel With Creation Of Urinary Opening |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51596. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51596 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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