CPT 51605 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| CMS | $37.20 Physician Fee Schedule |
National average reimbursement for CPT 51605 by major payers:

$55.17

$81.31

$61.62

$77.61
| 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 51605 | ||||||
United | 51605 | $561.00 | 1922230853 - CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC | 270476822 - (NY) CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $633.00 | 1104082692 - OLD TESSON SURGERY CENTER, L.P., OLD TESSON SURGERY CENTER | 262876334 - (MO) OLD TESSON SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $574.00 | 1912933680 - SOUTHWESTERN AMBULATORY SURGERY CENTER, LLC | 562422009 - (PA) SOUTHWESTERN AMBULATORY SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $531.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $250.00 | 1538280284 - PHYSICIANS SURGERY CENTER OF MODESTO INC, RIVER SURGICAL INSTITUTE | 201088433 - (CA) PHYSICIANS SURGERY CENTER OF MODESTO DBA RIVER SURGICAL INSTITUTE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $574.00 | 1184680225 - CAPITAL CITY SURGICAL CENTER LLC, CAPITAL CITY SURGICAL CENTER LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $112.00 | 1750468583 - TEXAS EYE SURGERY CENTER, LLC | 202928367 - (TX) TEXAS EYE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $328.00 | 1083796221 - SOUTHERN INDIANA SURGERY CENTER, LLC, SOUTHERN INDIANA SURGERY CENTER | 351829838 - (IN) SOUTHERN INDIANA SURGERY CENTER | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $574.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $155.00 | 1386177376 - EXECUTIVE SURGERY CENTER OF LITTLE ROCK, LLC | 820817194 - (AR) EXECUTIVE SURGERY CENTER OF LITTLE ROCK LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $574.00 | 1174592844 - AUDUBON AMBULATORY SURGERY CENTER LLC, AUDUBON SURGERY CENTER | 841482638 - (CO) AUDUBON AMBULATORY SURGERY CENTER, LLC. | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $506.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $1231.00 | 1821528753 - KENNEDY CHERRY HILL SURGICAL CENTER LLC, JEFFERSON SURGERY CENTER - CHERRY HILL | 472462625 - (NJ) KENNEDY CHERRY HILL SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $574.00 | 1184680225 - CAPITAL CITY SURGICAL CENTER LLC, CAPITAL CITY SURGICAL CENTER LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51605 | $907.00 | 1558564344 - SURGERY CENTER OF ATLANTIS LLC | 260298828 - (FL) SURGERY CENTER OF ATLANTIS LLC | FL | 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 51605 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51605 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 51605 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 |
|---|---|---|
| 51600-CPT | Moderate | Injection Procedure For X-Ray Imaging Of The Bladder Or During Voiding |
| 51605-CPT | Low | Inject+Place Chain Ureth-Cystograph |
| 51610-CPT | Low | Inject.Proced.For Retrograde Urethrocyst |
| 51701-CPT | Low | Insertion Of Non-Indwelling Bladder Catheter (Eg, Straight Catheterization Of Residual Urine) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51605 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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