CPT 52441 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 59 - Distinct Procedural Service • SG - Scene to Hospital ESRD facility |
| Complexity Level | High |
| CMS | $1,161.56 Physician Fee Schedule |
National average reimbursement for CPT 52441 by major payers:
$1,346.40
$1,718.33
$1,816.85
$2,024.74
| 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 52441 | ||||||
United | 52441 | $1616.43 | 1174559686 - ASHLEY JERATH TATUM | 910946924 - (WA) NORTHWEST ASTHMA & ALLERGY CENTER | WA | Allergy & Immunology Physician (207K00000X) |
United | 52441 | $1686.70 | 1821047747 - JAMES ROCKWELL | 911481575 | WA | Otolaryngology Physician (207Y00000X) |
United | 52441 | $5029.06 | 1710995295 - REUBEN HUDSON | 912073120 | WA | Urology Physician (208800000X) |
United | 52441 | $3762.68 | 1245342419 - CLAIRE YANG | 912047402 | WA | Urology Physician (208800000X) |
United | 52441 | $1839.81 | 1578927398 - MATTHEW PEREZ | 910946924 - (WA) NORTHWEST ASTHMA & ALLERGY CENTER | WA | Allergy & Immunology Physician (207K00000X) |
United | 52441 | $3417.21 | 1952797763 - JULIO SLONGO | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Urology Physician (208800000X) |
United | 52441 | $2268.98 | 1922538883 - MANISHA CHAND | 650556041 | WA | Multi-Specialty Group (193200000X) |
United | 52441 | $1625.40 | 1740232248 - DAVID RICE | 910729255 - (WA) PUBLIC HOSPITAL DISTRICT NO 2 | WA | Urology Physician (208800000X) |
United | 52441 | $3842.53 | 1639344534 - ALVARO LUCIONI | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | Urology Physician (208800000X) |
United | 52441 | $3713.84 | 1821249939 - PROVIDENCE HEALTH & SERVICES, PMG NW WA MC FAMILY MEDICINE | 320261234 | WA | Multi-Specialty Group (193200000X) |
United | 52441 | $1815.81 | 1982788220 - CASCADE REGIONAL EYE CENTER INC PS, THE HARMAN EYE CLINIC ASC | 911719913 - SIGHT PARTNERS, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52441 | $300.85 | 1295014041 - BRIGHT EYES, INC., JUANITA VISION CLINIC | 452700755 - (WA) BRIGHT EYES INC | WA | Multi-Specialty Group (193200000X) |
United | 52441 | $490.69 | 1558300434 - PROLIANCE SURGEONS INC., P.S., ORTHOPEDIC PHYSICIAN ASSOCIATES MRI | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Multi-Specialty Group (193200000X) |
United | 52441 | $3494.62 | 1689107880 - TRAVIS LANE | 912073120 | WA | Multi-Specialty Group (193200000X) |
United | 52441 | $395.00 | 1902228455 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE SURGERY AND PROCEDURE CENTER | 881232814 - (WA) PROVIDENCE SURGERY AND PROCEDURE CENTER LLC | WA | 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 52441 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52441 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 52441 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 |
|---|---|---|
| 52441-CPT | High | Once Per Dos Cystourethroscopy, W/Insertion Of Permanent Adjustable Transprostatic Implant; Single Implant- Rn Review >=5/1/2018; Deny Inv/N10=3/11/2016-4/30/2018 |
| 52442-CPT | Moderate | Cystourethroscopy With Insertion Of Permanent Adjustable Transprostatic Implant; Each Additionalpermanent Adjustable Transprostatic Implant (List Separately In Addition To Code For Primary Procedure) |
| 52601-CPT | Moderate | Transurethral Electrosurgical Resection Of Prostate, Including Control Of Postoperative Bleeding, Complete (Vasectomy, Meatotomy, Cystourethroscopy, Urethral Calibration And/Or Dilation, And Internal Urethrotomy Are Included) |
| 52630-CPT | Moderate | Transurethral Resection; Residual Or Regrowth Of Obstructive Prostate Tissue Including Control Of Postoperative Bleeding, Complete (Vasectomy, Meatotomy, Cystourethroscopy, Urethral Calibration And/Or Dilation, And Internal Urethrotomy Are Included) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52441. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52441 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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