Data Platform
Sign InTry for Free

CPT 51940 Fee Schedule

Last Verified: January 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.

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
Medicare Fee ScheduleView Medicare rates for 51940

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$1146.001023604931 - ADVANCED SPINE AND PAIN SURGERY CENTERS LLC854282481 - (AZ) ADVANCED SPINE AND PAIN SURGERY CENTERS LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$360.001356314249 - COLUMBIA ASC LLC, COLUMBIA GASTROINTESTINAL ENDOSCOPY CENTER621657449 - (SC) THE COLUMBIA ASC, LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$104.001578535233 - SUN CITY OPHTHALMOLOGY ASC LLC, EYE INSTITUTE AT BOSWELL621737549 - (AZ) SUN CITY OPHTHALMOLOGY ASSOC LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1167.001255373601 - CHESTERFIELD AMBULATORY SURGERY CENTER LP, CHESTERFIELD SURGERY CENTER203834076 - (MO) CHESTERFIELD AMBULATORY SURGERY CENTER LPMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$7400.001811172729 - INDIANA ENDOSCOPY CENTERS LLC, INDIANA ENDOSCOPY CENTER WEST208398421INAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$330.001134109523 - MIDWEST SURGERY CENTER, L.C.481201894 - (KS) MIDWEST SURGERY CENTER, LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$734.001053353359 - VISION SURGERY & LASER CENTER, LLC931308251 - (OR) VISION SURGERY LASER CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$514.001750927190 - HERMITAGE ENDOSCOPY CENTER INC841815468 - (PA) HERMITAGE ENDOSCOPY CENTER INCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$4300.001689639692 - SURGICAL CENTER OF SOUTH JERSEY LIMITED PARTNERSHIP222709324NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$2013.001760035158 - LEIGH ORTHOPEDIC SURGERY CENTER, LLC832402528 - (VA) LEIGH ORTHOPEDIC SURGERY CENTER LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1064.001841712452 - SAINT THOMAS SURGERY CENTER NEW SALEM, LLC822137177 - (TN) SAINT THOMAS SURGERY CENTER NEW SALEM LLCTNAmbulatory 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$349.001639365240 - SAVANNAH PAIN CENTER, LLC203978153 - (GA) SAVANNAH PAIN CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$1049.001053764779 - SURGCENTER OF ST. LUCIE, LLC475425011 - (FL) SURGCENTER OF ST. LUCIE, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
51940$740.001093974602 - EVERGREEN ENDOSCOPY CENTER, LLC412211130 - (CT) EVERGREEN ENDOSCOPY CENTER LLCCTAmbulatory 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

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 51940) and we'll show you how you compare in 15 minutes or less.