CPT 52010 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $349.99 Physician Fee Schedule |
National average reimbursement for CPT 52010 by major payers:
$470.70
$529.53
$526.67
$640.22
| 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 52010 | ||||||
United | 52010 | $402.00 | 1841270675 - EYECARE CONSULTANTS SURGERY CENTER, LLC, EYECARE CONSULTANTS SURGERY CENTER | 621619550 - (IN) EYECARE CONSULTANTS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $819.50 | 1467999813 - WEBSTER OUTPATIENT SURGERY CENTER, LLC, WEBSTER OUTPATIENT SURGERY CENTER | 845046625 - (CA) WEBSTER OUTPATIENT SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $893.00 | 1316508252 - MINIMALLY INVASIVE SURGICENTER LLC | 842130499 - (FL) MINIMALLY INVASIVE SURGICENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $612.00 | 1548896095 - CAPITAL ORTHOPAEDIC SURGERY CENTER, LLC, CAPITAL ORTHOPAEDIC SURGERY CENTER | 833923443 - (MD) CAPITAL ORTHOPAEDIC SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $1138.00 | 1669075495 - SAINT JOSEPH HEALTH ASC LLC | 852155230 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $487.00 | 1033181862 - EL PASO ASC LP, ENDOSCOPY CENTER OF EL PASO | 621731682 - (TX) EL PASO ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $1124.00 | 1528332186 - LINDENHURST SURGERY CENTER LLC, RED OAKS SURGICAL SUITES | 364711459 - (IL) LINDENHURST SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $218.00 | 1295793974 - SANTA LUCIA SURGICAL CENTER LLC | 201918525 - (FL) SANTA LUCIA SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $348.00 | 1447258603 - SNOWDEN RIVER SURGERY CENTER LLC | 200946902 - (MD) SNOWDEN RIVER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $272.00 | 1841578978 - PHYSICIANS' SURGERY CENTER OF NEVADA LLC | 273741243 - (NV) PHYSICIANS SURGERY CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $2266.00 | 1174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER | 461848055 - (WI) AURORA GI ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $1553.00 | 1851029060 - COLORADO SPRINGS SURGICENTER, LLC | 862813124 - COLORADO SPRINGS SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $294.00 | 1700205150 - OHI WEST, INC, BAYFRONT HEALTH AMBULATORY SURGERY CENTER | 845074208 - (FL) OHI WEST INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $286.00 | 1679534614 - COURTYARD SURGERY PAVILION, INC, COURTYARD SURGERY PAVILION | 731728117 - (CA) COURTYARD SURGERY PAVILION INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52010 | $310.00 | 1295824100 - BETTER LIVING ENDOSCOPY CENTER | 640877920 - (MS) BETTER LIVING ENDOSCOPY CENTER | MS | 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 52010 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52010 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 52010 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 |
| 52005-CPT | Moderate | Cysto-Urethroscopy, With Ureteral Catheterization, With Or Without Irrigation, Instillation, Or Uretero-Pyelography, Exclusive Of Radiologic Service; |
| 52007-CPT | Moderate | Cystourethroscopy, With Ureteral Catheterization, With Or Without Irrigation, Instillation, Or Ureteropyelography, Exclusive Of Radiologic Service; With Brush Biopsy Of Ureter And/Or Renal Pelvis |
| 52010-CPT | Moderate | Cysto-Urethroscopy, With Ejaculatory Duct Catheterization, With Or Without Irrigation, Instillation, Or Duct Radiography, Exclusive Of Radiologic Service |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52010 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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