CPT 51845 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • AQ - Service in Health Professional Shortage Area |
| Complexity Level | Moderate |
| CMS | $568.65 Physician Fee Schedule |
National average reimbursement for CPT 51845 by major payers:

$726.84

$790.43

$791.94

$984.31
| 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 51845 | ||||||
United | 51845 | $7391.00 | 1174586606 - BELLEAIR SURGERY CENTER LTD | 742544710 - (FL) BELLEAIR SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $8387.00 | 1063442077 - INOVA LOUDOUN AMBULATORY SURGERY | 203523190 - (VA) INOVA LOUDOUN AMBULATORY SURGERY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $1175.00 | 1245566744 - CHESTERFIELD ASC, LLC | 811166184 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $5966.00 | 1295176139 - LOWCOUNTRY AMBULATORY CENTER, LLC | 274109893 - (SC) LOWCOUNTRY AMBULATORY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $3700.00 | 1427144336 - PORTLAND CLINIC, THE PORTLAND CLINIC SURGICAL CENTER | 930400952 - (OR) THE PORTLAND CLINIC LLP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $756.00 | 1902958226 - AMBULATORY SURGERY CENTER OF TUCSON, INC. | 262420656 - (AZ) AMBULATORY SURGERY CENTER OF TUCSON INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $2014.00 | 1477503175 - PALMS WEST SURGERY CENTER LTD | 201008459 - (FL) PALMS WEST SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $3407.00 | 1861931263 - METHODIST CRAIG RANCH SURGERY CENTER LLC | 352583971 - (TX) METHODIST CRAIG RANCH SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $5433.00 | 1306421268 - COLORADO UROLOGIC SURGERY CENTER, LLC, COLORADO UROLOGIC SURGERY CENTER | 851926897 - (CO) COLORADO UROLOGIC SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $1242.00 | 1295793974 - SANTA LUCIA SURGICAL CENTER LLC | 201918525 - (FL) SANTA LUCIA SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $1211.00 | 1922055235 - SEIDENBERG PROTZKO SURGERY CENTER LLC, MID ATLANTIC SURGERY PAVILION | 203363768 - (MD) SEIDENBERG PROTZKO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $3450.00 | 1164584066 - NAPERVILLE SURGICAL CENTRE LLC | 200433367 - (IL) NAPERVILLE SURGICAL CENTRE, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $20586.00 | 1609056290 - UCSD AMBULATORY SURGERY CENTER, LLC, UNIVERSITY AMBULATORY SURGERY CENTER | 261232189 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $3249.00 | 1578980421 - SUNSET RIDGE SURGERY CENTER, LLC | 463505336 - (NV) SUNSET RIDGE SURGERY CENTER, LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51845 | $650.00 | 1396899191 - ALTERNACARE | 311487187 - ALTERNACARE | OH | 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 51845 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51845 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 51845 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 51845. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51845 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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