CPT 51992 Fee Schedule
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.
| 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 • 51 - Multiple procedures • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 51992 |
National average reimbursement for CPT 51992 by major payers:
$1,021.36
$1,126.72
$1,169.08
$1,393.82
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 51992 | ||||||
United | 51992 | $991.00 | 1881695732 - REVISION ADVANCED SURGERY CENTER INC | 200734091 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $5427.00 | 1225091739 - OUTPATIENT WOMEN'S AND CHILDREN'S SURGERY CENTER, LTD | 432016059 - (TX) OUTPATIENT WOMENS AND CHILDRENS SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $4239.00 | 1609907211 - SHREWSBURY SURGERY CENTER, LLC, SHREWSBURY SURGERY CENTER | 223651945 - (NJ) SHREWSBURY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $3275.00 | 1871924027 - PRESTON SURGERY CENTER, LLC | 462415142 - (TX) PRESTON SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $1950.00 | 1972778579 - G A ENDOSCOPY CENTER, LLC | 262346936 - (MO) G A ENDOSCOPY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $4394.00 | 1437106846 - ANTIETAM UROSURGICAL CENTER LLC ASC | 522006832 - (MD) ANTIETAM UROSURGICAL CENTER LLC ASC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $731.00 | 1548254402 - LIVE OAK ENDOSCOPY CENTER, LLC | 10709517 - (FL) LIVE OAK ENDOSCOPY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $4641.00 | 1922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $3500.00 | 1225523970 - BURNSVILLE SURGERY CENTER, P.A. | 830965169 - (MN) BURNSVILLE SURGERY CENTER PA | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $9793.00 | 1114260254 - SPRING HILL SURGERY CENTER, LLC | 462325870 - (TN) SPRING HILL SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $6365.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $1061.00 | 1386885556 - THE ASC AT WAUGH CHAPEL | 263869837 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $2325.00 | 1033115472 - CAPLAN-BERKELEY, LLP, CAPLAN SURGERY CENTER | 571146952 - (TX) CAPLANBERKELEY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $2300.00 | 1619971470 - ARIZONA ADVANCED SURGERY CENTER, LLC | 202770438 - (AZ) ARIZONA ADVANCED SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $3489.00 | 1891312815 - SACRED HEART ASC, LLC | 830521940 - (FL) SACRED HEART ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 51992 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 51992 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 51992 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 |
|---|---|---|
| 51920-CPT | High | Close Fistula Vesicouterine |
| 51960-CPT | High | Enterocystoplasty W Bowel Anastomosis |
| 51990-CPT | Moderate | Laparoscopy, Surgical; Urethral Suspension For Stress Incontinence |
| 51992-CPT | High | Laparoscopy, Surgical; Sling Operation For Stress Incontinence (Eg, Fascia Or Synthetic) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 51992. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 51992 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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