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See a sample rate comparisonCPT 51820 Fee Schedule
Last Verified: October 2026
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.
Cystourethroplasty W/ Unilat Or Bilate Ureteroneocystostomy, Cystourethroplasty With Unilateral Or Bilateral Ureteroneocystostomy
| 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 80 - Assistant surgeon LT - Left side of body AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 51820 |
| Medicaid Fee Schedule | View Medicaid rates for 51820 |
National average reimbursement for CPT 51820 by major payers:
$1,326.95
$1,467.09
$1,524.03
$1,777.68
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CPT 51820
5 of 25 sample ratesHigher to lower in this preview
Gastro-Surgi Center Of New Jersey
Gastro-Surgi Center Of Nj
$4,300.00Published rateTamarac Surgery Center LLC, The Surgery Center Of Ft Lauderdale
Tamarac Surgery Center LLC
$1,049.00Published rateRochester Surgery Center, P.C.
Rochester Surgery Center PC
$695.00Published rateMiddletown Endoscopy Asc LLC, The Gi Endoscopy Center
Middletown Endoscopy Asc LLC
$514.00Published rateSani Eye Center, Inc., Sani Eye Surgery Center
Sani Eye Center Inc
$81.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 51820 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51820 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 51820 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 |
|---|---|---|
| 51800-CPT | High | Revision Of Bladder Urethra, 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 W/ Unilat Or Bilate Ureteroneocystostomy, Cystourethroplasty With Unilateral Or Bilateral Ureteroneocystostomy |
| 51840-CPT | Moderate | Anterior Vesicourethropexy Or, Anterior Vesicourethropexy Or Urethropexy (Egmarshall-Marchetti- Krantz Burch) Simple Anterior Vesicourethropexy Or Urethropexy (Eg |
| 51841-CPT | Moderate | Anterior Vesicourethropexy Or, Anterior Vesicourethropexy Or Urethropexy (Egmarshall-Marchetti-Krantz Burch) Complicated (Eg Secondary Repair) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51820 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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