CPT 52649 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 • GC - Service performed by resident under supervision • 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 52649 |
National average reimbursement for CPT 52649 by major payers:
$1,052.97
$1,166.95
$1,242.91
$1,432.64
| 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 52649 | ||||||
United | 52649 | $5433.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $2550.00 | 1508840893 - PARKWAY SURGERY CENTER | 621799370 - (SC) PARKWAY SURGERY CENTER, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $5249.00 | 1659517019 - SURGERY CENTER OF PEMBROKE PINES, LLC | 263364068 - (FL) SURGERY CENTER OF PEMBROKE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $1725.00 | 1013914985 - ROANOKE AMBULATORY SURGERY CENTER, LLC, ROANOKE AMBULATORY SURGERY CENTER | 10691564 - (VA) ROANOKE AMBULATORY SURGERY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $6506.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $3824.00 | 1063999662 - SOUTHERN KENTUCKY SURGICENTER, LLC, GREENVIEW SURGERY CENTER | 474897131 - (KY) SOUTHERN KENTUCKY SURGICENTER LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $2482.00 | 1700887155 - TEXAS MIDWEST SURGERY CENTER, LLC | 752800127 - (TX) TEXAS MIDWEST SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $3592.00 | 1073816690 - PENN STATE HERSHEY ENDOSCOPY CENTER LLC | 274000022 - (PA) PENN STATE HERSHEY ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $2618.00 | 1679858849 - THE EASTSIDE ENDOSCOPY CENTER, LLC | 911665997 - (WA) THE EASTSIDE ENDOSCOPY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $7770.00 | 1083644124 - MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP, MEMORIAL HERMANN SURGERY CENTER SOUTHWEST | 202866884 - (TX) MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $2800.00 | 1760794218 - NSC MANAGEMENT COMPANY, INC., ENDEAVOR SURGICAL CENTER | 954683164 - (CA) NORTHRIDGE SURGERY AND PAIN MANAGEMENT CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $1919.00 | 1285678979 - BAY SURGERY CENTERS LLC, CLEARWAY SURGERY CENTER OF ANNAPOLIS | 204934078 - (MD) BAY SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $1516.00 | 1508813627 - FOUR STATES SURGERY CENTER, PC, FOUR STATES SURGERY CENTER, | 201498725 - (MO) FOUR STATES SURGERY CENTER, PC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $1471.00 | 1336208081 - ATLANTIC SURGERY CENTER OF JACKSONVILLE BEACH | 593740436 - (FL) ATLANTIC SURGERY CENTER OF JACKSONVILLE BEACH | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52649 | $3139.00 | 1760834295 - RESURGENS EAST SURGERY CENTER, LLC | 811693887 - (GA) RESURGENS EAST SURGERY CENTER LLC | GA | 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 52649 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52649 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 52649 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 |
| 52649-CPT | High | Laser Enucleation Of The Prostate With Morcellation Including Control Of Postoperative Bleeding Complete (Vasectomy Meatotomy Cystourethroscopy Urethral Calibration And/Or Dilation Internal Urethrotomy & Transurethral Resection Of Prostate 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 52649. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52649 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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