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See a sample rate comparisonCPT 51980 Fee Schedule
Last Verified: October 2026
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.
Drain Bladder Through Skin, Surgical Creation Of An Opening Between The Bladder And The Skin Of The Lower Abdomen For Urine Drainage.
| 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 GC - Service performed by resident under supervision 82 - Assistant surgeon - no qualified resident |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 51980 |
| Medicaid Fee Schedule | View Medicaid rates for 51980 |
National average reimbursement for CPT 51980 by major payers:
$890.45
$958.05
$994.61
$1,166.50
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CPT 51980
5 of 25 sample ratesHigher to lower in this preview
Medstar Surgery Center At Lafayette Centre, LLC
Medstar Surgery Center At Lafayette Centre LLC
$2,655.00Published rateHuebner Creek Surgery Center, PLLC
Huebner Ambulatory Surgery Center LLC
$2,250.00Published rateHealthqare Services Asc LLC, Healthqare Services Asc LLC
Healthqare Services Asc LLC
$1,350.00Published rateSt Michaels Surgery Center Inc.
St Michaels Surgery Center Inc
$975.00Published rateAmbulatory Surgical Care, LLC
Ambulatory Surgical Care LLC
$450.00Published rate
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See a sample payer proposalCPT 51980 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51980 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 51980 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 |
|---|---|---|
| 51940-CPT | High | Close Exstrophy |
| 51960-CPT | High | Enterocystoplasty W Bowel Anastomosis |
| 51980-CPT | Moderate | Drain Bladder Through Skin, Surgical Creation Of An Opening Between The Bladder And The Skin Of The Lower Abdomen For Urine Drainage. |
| 51990-CPT | Moderate | Surgery For Bladder Control, Surgery To Relieve Stress Incontinence (Urine Leakage). The Procedure May Modify The Bladder Muscles Or The Bladder Opening And Urethra. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51980. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51980 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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