CPT 51800 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 |
| Common Modifiers | • None • 51 - Multiple procedures • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 51800 |
National average reimbursement for CPT 51800 by major payers:
$1,320.00
$1,404.50
$1,474.02
$1,736.25
| 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 51800 | ||||||
United | 51800 | $874.00 | 1528145778 - OVERLAKE AMBULATORY SURGERY CENTER, LLC, OVERLAKE SURGERY CENTER LLC | 911925618 - (WA) OVERLAKE AMBULATORY SURGERY CENTER, | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $523.00 | 1841672615 - ALLIANCE SURGERY CENTER AT AUGUSTA, LLC | 474382081 - (GA) ALLIANCE SURGERY CENTER AT AUGUSTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $200.00 | 1205925278 - LUDWICK LASER & SURGERY CENTER, LLC | 205159711 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $495.00 | 1821397654 - RENUE SURGERY CENTER OF WAYCROSS, LLC | 273847480 - (GA) RENUE SURGERY CENTER OF WAYCROSS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $112.00 | 1780604694 - CLEARVIEW SURGERY CENTER INC | 202828714 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $440.00 | 1831195379 - LARGO SURGERY LLC, WEST BAY SURGERY CENTER | 10553657 - (FL) LARGO SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $150.00 | 1689670390 - WILLIAMS EYE INSTITUTE, PC, WILLIAMS EYE SURGERY CENTER | 351401963 - (IN) WILLIAMS EYE INSTITUTE | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $1064.00 | 1811001860 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $600.00 | 1184689408 - EVERGREEN EYE CENTER, PLLC, EYE ASSOCIATES NORTHWEST SURGERY CENTER | 911610832 - (WA) EYE ASSOCIATES NORTHWEST, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $125.00 | 1952820037 - BOWDEN GASTRO ASSOCIATES LLC | 822738390 - (TN) BOWDEN GASTRO ASSOCIATES LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $520.00 | 1033220751 - ENDOSCOPY CENTER AT ST MARY | 205253494 - (PA) ENDOSCOPY CENTER AT ST MARY | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $4300.00 | 1801987805 - ENDO SURGI CENTER OF OLD BRIDGE LLC | 223679920 - (NJ) ENDO-SURGI CENTER OF OLD BRIDGE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $440.00 | 1225488216 - MADISON AVENUE SURGERY CENTER LLC | 475541001 - (ID) MADISON AVENUE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $1028.00 | 1295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51800 | $1049.00 | 1043803877 - PALM BEACH INTERNATIONAL SURGERY CENTER LLC, PALM BEACH INTERNATIONAL SURGERY CENTER AT THE PALEY INSTITUTE | 384092545 - (FL) PALM BEACH INTERNATIONAL SURGERY CENTER LLC | FL | 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 51800 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51800 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 51800 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 |
|---|---|---|
| 51715-CPT | Moderate | Endoscopic Injectn. Implant Material Into Tissues Of Ureth/Bladder Nec |
| 51720-CPT | Low | Bladder Instillation Anticarcinogenic Ag |
| 51800-CPT | High | Cystoplasty Or Cystourethroplasty, Plastic Operation On Bladder And/Or Vesical Neck (Anterior Y-Plasty, Vesical Fundus Resection), Any Procedure, With Or Without Wedge Resection Of Posterior Vesical Neck |
| 51820-CPT | High | Cystourethroplasty+Ureteroneocystos |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51800. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51800 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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