CPT 51728 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 • 52 - Reduced Services • 26 - Professional component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 51728 |
National average reimbursement for CPT 51728 by major payers:
$412.42
$440.12
$502.21
$601.67
| 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 51728 | ||||||
United | 51728 | $448.00 | 1477502979 - INLAND EAR NOSE AND THROAT A MEDICAL GROUP INC, FOOTHILL AMBULATORY SURGERY CENTER | 953300822 - (CA) M.M. KANOK, M.D., A MEDICAL CORPORA | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $626.00 | 1457460248 - OSC LLC, OMAHA SURGICAL CENER | 470693440 - (NE) OSC LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $469.00 | 1467783233 - SOUTH SOUND SURGERY, PLLC, AUBURN SURGICAL CENTER | 204413058 - (WA) SOUTH SOUND SURGERY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $514.00 | 1558327213 - SURGICARE OF JACKSON LTD | 752162993 - (MS) SURGICARE OF JACKSON LTD | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $434.00 | 1871529388 - PRG DALLAS ASC, LLC, CENTRAL POINT SURGERY CENTER | 752835144 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $650.00 | 1730153073 - EAST MEMPHIS UROLOGY CENTER, LP, UROCENTER | 621810940 - (TN) EAST MEMPHIS UROLOGY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $450.00 | 1659463669 - ARUSHA LLC, THE SURGERY CENTER OF CHESTER COUNTY | 233076222 - (PA) ARUSHA LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $550.00 | 1225627094 - GEORGIA INTERVENTIONAL PAIN | 851355715 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $457.00 | 1629008677 - OPEN ACCESS VASCULAR ACCESS CENTER, INC | 650973601 - (FL) OPEN ACCESS VASCULAR ACCESS CE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $650.00 | 1295339737 - BEST CENTERS OF AMERICA-OHIO, LLC | 852707643 - (OH) BEST CENTERS OF AMERICAOHIO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $679.00 | 1063514107 - OHIO SURGERY CENTER LLC | 870566551 - (OH) OHIO SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $652.00 | 1144275900 - MT LAUREL ENDOSCOPY CENTER L P | 562350370 - (NJ) MT LAUREL ENDOSCOPY CENTER L P | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $402.00 | 1437642857 - GEORGIA VASCULAR & VEIN CENTER | 822239594 - (GA) GEORGIA VASCULAR VEIN CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $487.00 | 1003205196 - PALM BEACH GARDENS REGIONAL SURGERY CENTER LLC | 874629018 - (FL) PALM BEACH REGIONAL OPCO LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51728 | $1419.00 | 1164513149 - ENDO-SURGI OF UNION ASC LLC | 223248249 - (NJ) ENDO-SURGI CENTER, P.A. | NJ | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 51728 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51728 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 51728 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 |
|---|---|---|
| 51725-CPT | Moderate | Cmg Simple |
| 51726-CPT | Moderate | Complex Cystometrogram-Eg,Calibrated Ele |
| 51727-CPT | Moderate | Complex Cystometrogram (Ie, Calibrated Electronic Equipment); With Urethral Pressure Profile Studies (Ie, Urethral Closure Pressure Profile), Any Technique |
| 51728-CPT | Moderate | Complex Cystometrogram (Ie, Calibrated Electronic Equipment); With Voiding Pressure Studies (Ie, Bladder Voiding Pressure), Any Technique |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51728. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51728 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 51728) and we'll show you how you compare in 15 minutes or less.