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 |
| Medicare Fee Schedule | View Medicare rates for 52450 |
National average reimbursement for CPT 52450 by major payers:
$627.30
$632.32
$685.82
$775.81
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 52450 | $2621.00 | 1780128553 - CAROLINAS ENDOSCOPY CENTER LLC | 814599818 - CAROLINAS ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $533.00 | 1578600979 - HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTER, METRO AMBULATORY SURGICAL CENTER | 522048920 - (MD) HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $10061.00 | 1174588099 - IU HEALTH ARNETT HOSPITAL, INC, ARNETT SURGERY CENTER, LLC | 263162145 - (IN) INDIANA UNIVERSITY HEALTH ARNETT INC | IN | 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 | $1816.00 | 1497165179 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF PHOENIX | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $2859.00 | 1841605318 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER, LLC, FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER-CITRUS PARK | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $691.00 | 1588962831 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1521.00 | 1811940141 - SOUTHPARK SURGERY CENTER LLC, SOUTHPARK SURGERY CENTER | 870714098 - (NC) SOUTHPARK SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $3510.00 | 1154840064 - SOUTHHEALTH ASC, LLC, EDINA SPECIALTY SURGERY CENTER | 822364607 - (MN) SOUTHHEALTH ASC LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1734.00 | 1780871319 - SURGICAL SPECIALISTS ASC, LLC | 208066886 - (FL) SURGICAL SPECIALISTS ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1543.00 | 1447613344 - PREMIER SURGICAL CENTER LLC | 811222482 - (MO) PREMIER SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $5625.00 | 1245575919 - MEMORIALCARE SURGICAL CENTER AT SADDLEBACK LLC, MEMORIALCARE SURGICAL CENTER LAGUNA WOODS | 203678259 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $720.00 | 1902863723 - OAK & MAIN SURGICENTER LLC | 223532371 - (NJ) OAK MAIN SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1018.00 | 1922486679 - ST LOUIS SPECIALTY SURGICAL CENTER, LLC | 611754451 - (MO) ST LOUIS SPECIALTY SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52450 | $1043.00 | 1093795031 - ARKANSAS OTOLARYNGOLOGY CENTER, P.A., AOC SURGERY CENTER, INC | 710411708 - (AR) ARKANSAS OTOLARYNGOLOGY CENTER, P.A. | AR | 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 | Cystourethrosc W/ Transurethr Resct Or Ncision Of Ejaculat, Cystourethroscopy With Transurethral Resection Or Incision Of Ejaculat |
| 52450-CPT | Moderate | Prostate Surgery, An Exam Of The Prostate Using A Scope (Cystourethroscopy) And Making A Cut To Allow For A Larger Passage For Urine To Flow. |
| 52601-CPT | Moderate | Prostatectomy Turp, 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 | Remove Prostate Regrowth, 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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