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CPT 51940 Fee Schedule

Last Verified: November 2025

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.

Close Exstrophy
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Urinary System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

22 - Increased Procedural Services

62 - Co-Surgeons

Complexity LevelHigh
CMS$1,583.36 Physician Fee Schedule

National average reimbursement for CPT 51940 by major payers:

bcbs

$2,055.31

uhc

$2,205.16

aetna

$2,289.06

cigna

$2,731.41

Preview provider-level rates for...
For billing codeCPT 51940
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 51940

United
51940$853.001831217231 - THE ENDOSCOPY CENTER AT BAINBRIDGE LLC205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1028.001790104248 - METRO SURGERY CENTER, LLC, METRO SURGERY CENTER, LP810587498 - (AZ) METRO SURGERY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1064.001093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC651198731 - (FL) THE SURGERY CENTER AT JENSEN BFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1801.001962431197 - SHAWNEE MISSION SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER SHAWNEE MISSION481243914 - (KS) SHAWNEE MISSION SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1200.001477792828 - PRECISION SURGICENTER LLC262185162 - (CA) PRECISION SURGICENTER, LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$520.001083955330 - BELLEVUE PLASTIC SURGERY CENTER, NEWVUE PLASTIC SURGERY PC263374369 - (WA) NEWVUE PLASTIC SURGERY, PCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1215.001083188478 - ROCKY HILL SURGERY CENTER, LLC833096156 - (CT) ROCKY HILL SURGERY CENTER, LLCCTAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$6659.001194997965 - INDIANAPOLIS ENDOSCOPY CENTER LLP352010874 - (IN) INDIANAPOLIS ENDOSCOPY CENTER LLPINAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$744.001407851090 - WICHITA FALLS ENDOSCOPY CENTER200474975 - (TX) WICHITA FALLS ENDOSCOPY CENTERTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$825.001093705774 - SURGICENTER OF MANSFIELD, LTD.311515255 - (OH) SURGICENTER OF MANSFIELD, LTD.OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$641.001417217183 - PAULSEN STREET SUGERY CENTER LLC824075002GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$394.001023005600 - PSHS BETA PARTNERS LTD, THE GABLES SURGICAL CENTER650848650 - (FL) PSHS BETA PARTNERS LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$514.001750927190 - HERMITAGE ENDOSCOPY CENTER INC841815468 - (PA) HERMITAGE ENDOSCOPY CENTER INCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$840.001568918746 - ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY, LLC812594417 - (FL) ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$515.001760849889 - SURGERY CENTER AT CORPORATE WAY LLC473812657 - (OH) SURGERY CENTER AT CORPORATE WAY LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 51940 vs. Other Surgical Procedures on the Urinary System Codes

The CPT 51940 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 51940 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.

CodeComplexityDescription
51845-CPTModerateAbdom-Vaginal Ves.Neck Suspen.W/Wo Endos
51860-CPTModerateCystorrhaphy Simple
51900-CPTHighClose Fistula Vesicovaginal Abd
51940-CPTHighClose Exstrophy

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51940. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 51940 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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