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See a sample rate comparisonCPT 51925 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.
Repair Bladder Passage, Surgery To Repair An Abnormal Passage (Fistula) In The Uterus. The Procedure May Include Removal Of The Uterus (Hysterectomy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None XE - Separate encounter |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 51925 |
| Medicaid Fee Schedule | View Medicaid rates for 51925 |
National average reimbursement for CPT 51925 by major payers:
$1,346.96
$1,418.83
$1,467.97
$1,737.96
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CPT 51925
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Stephenville
$9,124.00Published rateCentral Jersey Surgery Center LLC, Central Jersey Surgery Center
Central Jersey Surgery Center LLC
$1,049.00Published rateInnovative Surgery Center, LLC
Innovative Surgery Center LLC
$553.00Published rateWest Clinic Astc, West Clinic, PC
The West Clinic, PLLC
$420.00Published rateSloan Eye Clinic, Arkansas Surgery Center
Sloan Eye Clinic
$226.00Published rate
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See a sample payer proposalCPT 51925 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51925 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 51925 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 |
|---|---|---|
| 51845-CPT | Moderate | Abdomino-Vaginal Vesical Neck, Abdomino-Vaginal Vesical Neck Suspension With Or Withoutendoscopic Control (Eg Stamey Raz Modified Pereyra) |
| 51860-CPT | Moderate | Cystorrhaphy Suture Of Bladder Wound Njury Or Rupture; Smple, Cystorrhaphy Suture Of Bladder Wound Injury Or Rupture; Simple |
| 51900-CPT | High | Close Fistula Vesicovaginal Abd |
| 51925-CPT | High | Repair Bladder Passage, Surgery To Repair An Abnormal Passage (Fistula) In The Uterus. The Procedure May Include Removal Of The Uterus (Hysterectomy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51925. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51925 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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