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CPT 51785 Fee Schedule

Last Verified: November 2025

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.

Emg Anal/Urethral Sphincter
Key FactDetail
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 LevelModerate
CMS$382.34 Physician Fee Schedule

National average reimbursement for CPT 51785 by major payers:

bcbs

$462.98

uhc

$416.73

aetna

$512.47

cigna

$622.77

Preview provider-level rates for...
For billing codeCPT 51785
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 51785

United
51785$207.001912267592 - SURGCENTER AT NATIONAL HARBOR, LLC, HARBORSIDE SURGERY CENTER454110190 - (MD) HARBORSIDE SURGERY CENTERMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$339.001114291440 - PREMIER ASC LLC, PREMIER ORTHOPAEDIC SURGERY CENTER352433859TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$417.001912906157 - SOUTHERN SURGERY CENTER, LLC522200293 - (MS) SOUTHERN SURGERY CENTER LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$79.001205373057 - BAY AREA ASC LLC, AZURA SURGERY CENTER HOUSTON814821022 - (TX) BAY AREA ASC LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$79.001720262405 - BATON ROUGE LA ENDOSCOPY ASC LLC, LOUISIANA ENDOSCOPY CENTER261168310LAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$136.001174128359 - JEFFERSON ASC, LLC, VOLUNTEER SURGERY CENTER364934272 - (TN) JEFFERSON ASC LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$108.001679526297 - WEST BLOOMFIELD SURGERY CENTER, LLC, LAKES SURGERY CENTER200449191 - (MI) WEST BLOOMFIELD SURGERY CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$150.001720833163 - MIDWEST EYE CENTER363010536 - (IL) MIDWEST EYE CENTERILAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$531.001588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$100.001023123296 - ASSOCIATES SURGERY CENTERS, LLC510492139 - (PA) ASSOCIATES SURGERY CENTERS LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$424.001881375319 - MIDWEST SURGERY CENTER, LLC, MIDWEST SURGERY CENTER - EAGAN411537436 - (MN) MIDWEST SURGERY CENTERMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$580.001598949281 - POWAY CA MULTI SPECIALTY ASC LLC, POWAY SURGERY CENTER261158191 - (CA) POWAY CA MULTI-SPECIALTY ASC LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$95.001770572307 - BETHESDA SURGERY CENTER, LLC522080005 - (MD) BETHESDA SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$574.001265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGIFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51785$580.001114202892 - ALVARADO EYE SURGERY CENTER LLC453181784 - (CA) ALVARADO EYE SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
51736-CPTLowUroflowmetry Simple
51741-CPTLowComplex Uroflowmetry-Eg,Calibrate Electr
51784-CPTLowElectmygrph Study (Emg) Of Anal/Urthr Sphnctr, Oth Thn Needl, Any Tech
51785-CPTModerateEmg Anal/Urethral Sphincter

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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