CPT 52214 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 | • 22 - On Campus Outpatient Hospital • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $686.07 Physician Fee Schedule |
National average reimbursement for CPT 52214 by major payers:
$919.79
$1,016.69
$1,060.58
$1,220.07
| 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 52214 | ||||||
United | 52214 | $2865.00 | 1528016656 - VANTAGE SURGICAL ASSOCIATES, LLC, VANTAGE SURGERY CENTER | 450516750 - (NJ) VANTAGE SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $2990.00 | 1881001758 - ASUCH SURGERY CENTER | 455067682 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $819.50 | 1316231020 - DESERT VIEW ENDOSCOPY CENTER, LLC. | 272420135 - (CA) DESERT VIEW ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $839.00 | 1588879266 - BAYSIDE ENDOSCOPY CENTER LLC, EAST GREENWICH ENDOSCOPY CENTER | 200207545 - (RI) BAYSIDE ENDOSCOPY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $775.00 | 1811168164 - UROLOGIC SPECIALISTS OF NEW ENGLAND LLC | 208951188 - (RI) UROLOGIC SPECIALISTS OF NEW ENGLAND, LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $544.00 | 1417409285 - BEAUMONT ASC, LP, BEAUMONT HEART & VASCULAR SURGERY CENTER | 814050976 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $900.00 | 1457813107 - SURGEON'S SURGERY CENTER SORELLE PLLC | 831414422 - (NV) SURGEONS SURGERY CENTER SORELLE PLLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $1862.00 | 1295883973 - SUMMIT VENTURES OF SANTA BARBARA, LP, SUMMIT SURGERY CENTER | 770529514 - (CA) SUMMIT VENTURES OF SANTA BARBARA, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $926.00 | 1679658710 - STADIUM CAMPUS AMBULATORY SURGICAL CENTER, LLC, WILLS EYE SURGERY CENTER | 232981922 - (PA) STADIUM CAMPUS AMBULATORY SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $991.00 | 1073621512 - DIGESTIVE DISEASE CENTER | 880291959 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $819.50 | 1760074207 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC | 854253589 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $1632.00 | 1558053868 - LORAIN AMHERST SURGERY CENTER LLC | 853470191 - (OH) LORAIN AMHERST SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $2176.00 | 1083659866 - ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP, FOUNDATION SURGERY AFFILIATE OF SAN ANTONIO LP | 742976746 - (TX) ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $1847.00 | 1346969789 - ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC | 882744377 - (FL) ADVENTHEALTH SURGERY CENTER INNOVATION TOWER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52214 | $589.00 | 1942483433 - PREMIER PHYSICIANS CENTERS, INC | 341783789 - (OH) PREMIER PHYSICIANS CENTERS, INC. | OH | 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 52214 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52214 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 52214 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 |
|---|---|---|
| 51960-CPT | High | Enterocystoplasty W Bowel Anastomosis |
| 51980-CPT | Moderate | Vesicostomy Cutaneous |
| 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 |
| 52214-CPT | Moderate | Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) Of Trigone, Bladder Neck, Prostatic Fossa, Urethra, Or Periurethral Glands |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52214. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52214 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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