CPT 52450 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service • SG - Scene to Hospital ESRD facility |
| Complexity Level | Moderate |
| CMS | $465.47 Physician Fee Schedule |
National average reimbursement for CPT 52450 by major payers:
$627.30
$632.32
$685.82
$795.01
| 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 52450 | ||||||
United | 52450 | $2044.00 | 1740634369 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1157.00 | 1053985721 - ENDO SURGICAL CENTER OF KISSIMMEE, PLLC | 844377406 - (FL) ENDO SURGICAL CENTER OF KISSIMMEE PLLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1167.00 | 1962148510 - PVSCG, LLC | 842112909 - (TX) PVSCG LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1211.00 | 1386650778 - NORTH BEND MEDICAL CENTER INC, NBMC-DAY SURGERY | 371843700 | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $698.00 | 1245906403 - EHA SURGERY CENTER SARASOTA | 871620504 - (FL) EHA SURGERY CENTER SARASOTA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1150.00 | 1104829597 - HOGAN SURGICAL CENTER, P. A. | 300399671 - (MS) HOGAN SURGICAL CENTER P A | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1700.00 | 1164811923 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN AMBULATORY SURGERY CENTER-LEXINGTON | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $2353.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1003.00 | 1912053570 - BELMAR AMBULATORY SURGICAL CENTER, LLC | 200680241 - (CO) BELMAR AMBULATORY SURGICAL CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1102.00 | 1821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER | 205904530 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $776.00 | 1467582437 - NORTH FLORIDA SURGERY CENTER INC, NORTH FLORIDA SURGERY CENTER | 593377918 - (FL) NORTH FLORIDA SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1331.00 | 1295207579 - AGHAPY SURGICAL CENTER SC | 825243001 - (IL) AGHAPY SURGICAL CENTER SC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $3616.00 | 1154840064 - SOUTHHEALTH ASC, LLC, EDINA SPECIALTY SURGERY CENTER | 822364607 - (MN) SOUTHHEALTH ASC LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1035.00 | 1154538544 - COLLIER ENDOSCOPY & SURGERY CENTER | 651093702 - (FL) COLLIER ENDOSCOPY SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1036.00 | 1679612253 - WALKER SURGICAL CENTER LLC | 810635117 - (MI) WALKER SURGICAL CENTER LLC | MI | 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 52450 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52450 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 52450 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 |
|---|---|---|
| 52402-CPT | Moderate | Cystourethroscopy With Transurethral Resection Or Incision Of Ejaculatory Ducts |
| 52450-CPT | Moderate | Transurethral Incision Of Prostate |
| 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 52450. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52450 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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