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See a sample rate comparisonCPT 51785 Fee Schedule
Last Verified: October 2026
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.
Needle Electromyograph Studie (Emg) Of Anal Or Urethral Sphincter, Needle Electromyography Studies (Emg) Of Anal Or Urethral Sphincter A
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 26 - Professional component XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 51785 |
| Medicaid Fee Schedule | View Medicaid rates for 51785 |
National average reimbursement for CPT 51785 by major payers:
$462.98
$416.73
$512.47
$593.33
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CPT 51785
5 of 25 sample ratesHigher to lower in this preview
Rock Hill Surgery Center, LLC, Carolina Surgical Center
Rock Hill Surgery Center LLC
$2,879.00Published rateValencia Specialty Surgery PC
$580.00Published rateEndoscopy Center Of Toms River, LLC
Endoscopy Center Of Toms River LLC
$345.00Published rateDeer Creek Surgery Center, LLC
$122.00Published ratePodiatry Associates Ambulatory Surgical Centers LLC
$45.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 51785 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51785 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 51785 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 |
|---|---|---|
| 51736-CPT | Low | Bladder Emptying Test, A Bladder Emptying Test Is A Screening Procedure That Measures Urine Flow. It Can Help Identify Problems In The Urinary Tract As Well As Measure The Ability To Urinate And The Function Of Related Muscles. |
| 51741-CPT | Low | Bladder Emptying Test, A Bladder Emptying Test Is A Screening Procedure That Measures Urine Flow. It Can Help Identify Problems In The Urinary Tract As Well As Measure The Ability To Urinate And The Function Of Related Muscles. |
| 51784-CPT | Low | Electromyograph Studie (Emg) Of Anal Or Urethral Sphincter, Electromyography Studies (Emg) Of Anal Or Urethral Sphincter Other Th |
| 51785-CPT | Moderate | Needle Electromyograph Studie (Emg) Of Anal Or Urethral Sphincter, Needle Electromyography Studies (Emg) Of Anal Or Urethral Sphincter A |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51785 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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