Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 51990 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.
Surgery For Bladder Control, Surgery To Relieve Stress Incontinence (Urine Leakage). The Procedure May Modify The Bladder Muscles Or The Bladder Opening And Urethra.
| 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 AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 51990 |
| Medicaid Fee Schedule | View Medicaid rates for 51990 |
National average reimbursement for CPT 51990 by major payers:
$922.32
$1,010.27
$1,061.46
$1,220.41
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 51990.
CPT 51990
5 of 25 sample ratesHigher to lower in this preview
Aurora Gi Asc LLC, Wisconsin Digestive Health Center
Aurora Gi Asc LLC
$12,746.00Published rateLafayette Surgery Center Limited Partnership
$5,117.00Published rateTampa Bay Surgery Center Associates,Ltd
Tampa Bay Surgery Center Assoc
$3,800.00Published rateArizona Surgical Specialists Center, LLC, Arizona Surgical Specialists Center, LLC - Scottsdale
Arizona Surgical Specialists Center LLC
$2,467.00Published ratePrinceton Eye Group PA, Eye Surgery Princeton
Princeton Eye Group
$851.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 51990 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51990 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 51990 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) |
| 51920-CPT | High | Repair Bladder Passage, Surgery To Repair An Abnormal Passage (Fistula) In The Uterus. The Procedure May Include Removal Of The Uterus (Hysterectomy). |
| 51960-CPT | High | Enterocystoplasty W Bowel Anastomosis |
| 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 51990. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51990 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 51990) and we'll show you how you compare in 15 minutes or less.