CPT 52647 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 78 - Return to OR - related procedure • SG - Scene to Hospital ESRD facility • GR - Hospital ESRD facility to Residence • UB • AA - Anesthesia by anesthesiologist |
| Complexity Level | High |
| CMS | $1,462.71 Physician Fee Schedule |
National average reimbursement for CPT 52647 by major payers:
$2,116.00
$2,504.64
$2,359.42
$2,726.59
| 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 52647 | ||||||
United | 52647 | $1462.00 | 1497347934 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC | 854253589 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $3010.00 | 1437191731 - EL DORADO SURGERY CENTER LP, TUCSON SURGERY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $2300.00 | 1336649714 - HEALTHQARE SERVICES ASC LLC, HEALTHQARE SERVICES ASC LLC | 815460194 - (VA) HEALTHQARE SERVICES ASC LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $2040.00 | 1841858735 - ELITE AMBULATORY SURGERY CENTER, LLC | 841973218 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $1666.00 | 1407851090 - WICHITA FALLS ENDOSCOPY CENTER | 200474975 - (TX) WICHITA FALLS ENDOSCOPY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $2660.00 | 1093726796 - ROCKY MOUNTAIN EYE SURGERY CENTER INC | 810493712 - (MT) ROCKY MOUNTAIN EYE SURGERY CENTER INC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $766.00 | 1497831523 - BOSTON IVF, INC., THE SURGERY CENTER OF WALTHAM | 42921956 - (MA) BOSTON IVF, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $4588.00 | 1346207875 - GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | 364053840 - (NC) GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $1310.51 | 1689387094 - CHRISTINA HAMON | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 52647 | $3533.00 | 1457370447 - ORTHOPEDIC ASSOCIATES SURGERY CENTER LLC | 200446252 - (CT) ORTHOPEDIC ASSOCIATES SURGERY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $5433.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $5267.00 | 1962435990 - NORTHERN MONMOUTH REGIONAL SURGERY CENTER LLC, CENTER FOR BONE AND JOINT SURGERY | 201026094 - (NJ) NORTHERN MONMOUTH REGIONAL SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $2272.00 | 1972179208 - IDAHO OTOLOGIC SURGERY CENTER, LLC, SYRINGA OUTPATIENT SURGERY CENTER | 852522925 - (ID) IDAHO OTOLOGIC SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $5433.00 | 1649310111 - CROWN POINT SURGERY CENTER, LLC, CROWN POINT SURGERY CENTER | 810641475 - (CO) CROWN POINT SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52647 | $2277.00 | 1922022425 - CASCADE SURGERY CENTER LLC | 202354326 - (OR) CASCADE SURGERY CENTER LLC | OR | 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 52647 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52647 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 52647 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 |
|---|---|---|
| 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) |
| 52640-CPT | Moderate | Txureth.Resec;Postop.B.N.Contractur |
| 52647-CPT | High | Laser Coagulation Of Prostate, Including Control Of Postoperative Bleeding, Complete (Vasectomy, Meatotomy, Cystourethroscopy, Urethral Calibration And/Or Dilation, And Internal Urethrotomy Are Included If Performed) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52647. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52647 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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