CPT 51792 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 • 51 - Multiple procedures • 26 - Professional component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 51792 |
National average reimbursement for CPT 51792 by major payers:
$288.59
$320.61
$343.66
$434.88
| 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 51792 | ||||||
United | 51792 | $212.00 | 1871007880 - SOUTHWEST ENDOSCOPY PARTNERS LLC | 822948062 - (CO) SOUTHWEST ENDOSCOPY PARTNERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $297.00 | 1346508520 - FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | 270870899 - (NJ) FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $1096.00 | 1336437482 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $140.00 | 1366989741 - CENTER FOR SPINE INTERVENTIONS ASC 3, LLC | 813327243 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $170.00 | 1578003208 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $150.00 | 1376002469 - BVA UNITED LLC, ALPHA SURGICAL CENTER | 814953017 - (TX) BVA UNITED LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $118.00 | 1700205150 - OHI WEST, INC, BAYFRONT HEALTH AMBULATORY SURGERY CENTER | 845074208 - (FL) OHI WEST INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $142.00 | 1770837866 - SPINE AND PAIN PHYSICIANS SURGERY CENTER, LLC | 454831116 - (TN) SPINE AND PAIN PHYSICIANS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $350.00 | 1629016555 - SURGICAL ASSOCIATES NORTHWEST, PC, RAINIER SURGICAL CENTER | 911996643 - (WA) SURGICAL ASSOCIATES NORTHWEST, PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $125.00 | 1548216914 - UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | 450470832 - (TN) UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $254.00 | 1396738936 - WARREN GASTRO ENDOSCOPY CTR INC | 341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $688.00 | 1114202892 - ALVARADO EYE SURGERY CENTER LLC | 453181784 - (CA) ALVARADO EYE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $88.00 | 1316969058 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $574.00 | 1659517019 - SURGERY CENTER OF PEMBROKE PINES, LLC | 263364068 - (FL) SURGERY CENTER OF PEMBROKE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51792 | $112.00 | 1093895757 - PATRICK D REEVES MDPA, WILSON SURGICENTER | 412062384 - (TX) PATRICK D. REEVES, M.D., P.A. | TX | 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 51792 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51792 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 51792 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 |
|---|---|---|
| 51784-CPT | Low | Electmygrph Study (Emg) Of Anal/Urthr Sphnctr, Oth Thn Needl, Any Tech |
| 51785-CPT | Moderate | Emg Anal/Urethral Sphincter |
| 51792-CPT | Moderate | Stimulus Evoked Response |
| 51797-CPT | Moderate | Voiding Pressure Studies (Vp); Intra-Abdominal Voiding Pressure (Ap) (Rectal Gastric Intraperi- Toneal)(List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51792. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51792 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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