CPT 51785 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| CMS | $382.34 Physician Fee Schedule |
National average reimbursement for CPT 51785 by major payers:

$462.98

$416.73

$512.47

$622.77
| 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 51785 | ||||||
United | 51785 | $207.00 | 1912267592 - SURGCENTER AT NATIONAL HARBOR, LLC, HARBORSIDE SURGERY CENTER | 454110190 - (MD) HARBORSIDE SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $339.00 | 1114291440 - PREMIER ASC LLC, PREMIER ORTHOPAEDIC SURGERY CENTER | 352433859 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $417.00 | 1912906157 - SOUTHERN SURGERY CENTER, LLC | 522200293 - (MS) SOUTHERN SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $79.00 | 1205373057 - BAY AREA ASC LLC, AZURA SURGERY CENTER HOUSTON | 814821022 - (TX) BAY AREA ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $79.00 | 1720262405 - BATON ROUGE LA ENDOSCOPY ASC LLC, LOUISIANA ENDOSCOPY CENTER | 261168310 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $136.00 | 1174128359 - JEFFERSON ASC, LLC, VOLUNTEER SURGERY CENTER | 364934272 - (TN) JEFFERSON ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $108.00 | 1679526297 - WEST BLOOMFIELD SURGERY CENTER, LLC, LAKES SURGERY CENTER | 200449191 - (MI) WEST BLOOMFIELD SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $150.00 | 1720833163 - MIDWEST EYE CENTER | 363010536 - (IL) MIDWEST EYE CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $531.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $100.00 | 1023123296 - ASSOCIATES SURGERY CENTERS, LLC | 510492139 - (PA) ASSOCIATES SURGERY CENTERS LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $424.00 | 1881375319 - MIDWEST SURGERY CENTER, LLC, MIDWEST SURGERY CENTER - EAGAN | 411537436 - (MN) MIDWEST SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $580.00 | 1598949281 - POWAY CA MULTI SPECIALTY ASC LLC, POWAY SURGERY CENTER | 261158191 - (CA) POWAY CA MULTI-SPECIALTY ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $95.00 | 1770572307 - BETHESDA SURGERY CENTER, LLC | 522080005 - (MD) BETHESDA SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $574.00 | 1265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC | 651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51785 | $580.00 | 1114202892 - ALVARADO EYE SURGERY CENTER LLC | 453181784 - (CA) ALVARADO EYE SURGERY CENTER LLC | CA | 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 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.
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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