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 |
| CMS | $811.57 Physician Fee Schedule |
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 | $2035.00 | 1942202221 - NORTHLAKE ENDOSCOPY, LLC | 721515370 - (LA) NORTHLAKE ENDOSCOPY LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $5105.00 | 1174708390 - ORTHOPAEDIC SPECIALTY SURGERY CENTER LLC, ORTHOPAEDIC & SPECIALTY SURGERY CENTER | 263119034 - (CT) ORTHOPAEDIC SPECIALTY SURGERY CENTER, LLC | CT | 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 | $2526.00 | 1922016898 - JAMES TRICE MD PA, DIGESTIVE DISEASE CENTER | 710758882 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $5040.00 | 1700492170 - MERCY HEALTH BOARDMAN SURGERY | 863462441 - (OH) BSMH AMBULATORY VENTURES II LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $3458.00 | 1881147965 - ULNA SURGERY CENTER LLC | 813050347 - (GA) ULNA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $4121.00 | 1972114171 - SURGERY CENTER OF OAKLAND LP | 851685384 - (CA) SURGERY CENTER OF OAKLAND, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $3452.00 | 1659409241 - EYE SURGERY CENTER, LOREN BARRUS & PAUL SCHULTZ PTRS | 931126853 - (OR) EYE SURGERY CENTER | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $743.00 | 1124092945 - ROCKLEDGE FL ENDOSCOPY ASC LLC, SPACE COAST ENDOSCOPY CENTER | 200073131 - (FL) ROCKLEDGE FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $918.00 | 1194999359 - JEFFREY L BOBER DPM PA, JEFFREY L BOBER DPM PA ASC | 521706931 - (MD) JEFFREY L BOBER DPM PA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $4000.00 | 1124484019 - EDISON SURGERY CENTER LLC | 475016492 - (NJ) EDISON SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $979.00 | 1780656801 - CINCINNATI ASC LLC, UNIVERSITY ENDOSCOPY CENTER | 621671378 - (OH) CINCINNATI ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $4603.00 | 1891881926 - GASTRO-SURGI CENTER OF NEW JERSEY | 223472632 - (NJ) GASTRO-SURGI CENTER OF NJ | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $2055.00 | 1386300119 - LEE HEALTHCARE INVESTMENTS, LLC, LEE HEALTH UROLOGY SURGERY CENTER | 843798404 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 51992 | $1700.00 | 1760594279 - FILUTOWSKI EYE INSTITUTE PA, SUNRISE SURGICAL CENTER | 593111497 - (FL) FILUTOWSKI EYE INSTITUTE, P.A. | 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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