CPT 51720 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 • 59 - Distinct Procedural Service • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| CMS | $86.37 Physician Fee Schedule |
National average reimbursement for CPT 51720 by major payers:
$116.72
$130.96
$142.88
$161.41
| 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 51720 | ||||||
United | 51720 | $98.00 | 1770753998 - SKIN CANCER TREATMENT CENTER, L.L.C. | 262051034 - (MD) SKIN CANCER TREATMENT CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $1029.00 | 1184877219 - THR/STT ROCKWALL ASC, LLC | 262429878 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $89.00 | 1083837926 - HERITAGE EYE SURGERY CENTER, LLC, PRECISION VISION SURGERY CENTER | 731097247 - (OK) EDWARD D. GLINSKI, D.O. & ACCOCIATES, INC. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $279.00 | 1972778579 - G A ENDOSCOPY CENTER, LLC | 262346936 - (MO) G A ENDOSCOPY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $531.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $566.00 | 1245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN | 823682684 - (FL) SURGCENTER CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $420.00 | 1184697930 - THE ALEXANDRIA OPHTHALMOLOGY ASC LLC, WALLACE LASER AND SURGERY CENTER | 752830937 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $170.00 | 1619370434 - SANDPOINT SURGERY CENTER LLC | 465723093 - (ID) SANDPOINT SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $857.00 | 1336154152 - A CENTER FOR FOOT AND ANKLE SURGERY PA, THE CENTER FOR SPECIAL SURGERY OF HAWTHORNE | 223284458 - (NJ) A CENTER FOR FOOT AND ANKLE SU | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $1187.00 | 1154454205 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | 751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $120.00 | 1861930729 - FRESNO SPECIALTY SURGERY CENTER PC | 814226298 - (CA) FRESNO SPECIALTY SURGERY CENTER PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $75.00 | 1376580498 - SAME DAY SURGERY CENTERS OF FLORIDA LLC, SAME DAY SURGERY CENTER | 201804147 - (FL) SAME DAY SURGERY CENTERS OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $107.00 | 1255526265 - CONROE TX ENDOSCOPY ASC LLC, RIVER OAKS ENDOSCOPY CENTER | 260269714 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $1127.00 | 1316072234 - ARIA HEALTH SYSTEM, ARIA HEALTH FRANKFORD CAMPUS SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51720 | $200.00 | 1427183664 - LAGRECA EYE CLINIC, P.C., THE EYE CLINIC SURGICENTER | 320016290 - LAGRECA EYE CLINIC, PC | WY | 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 51720 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51720 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 51720 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51720 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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