CPT 52700 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $432.80 Physician Fee Schedule |
National average reimbursement for CPT 52700 by major payers:
$560.52
$589.05
$618.26
$738.49
| 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 52700 | ||||||
United | 52700 | $2000.00 | 1720227945 - WESTERN CONNECTICUT ORTHOPEDIC SURGICAL CENTER LLC, THE HAND CENTER OF WESTERN CONNECTICUT LLC | 61521999 - (CT) THE HAND CENTER OF WESTERN CONNECTICUT, L.L.C. | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $1639.00 | 1306973235 - DIGESTIVE DISEASE & ENDOSCOPY CENTER, LLC, DIGESTIVE DISEASE & ENDOSCOPY CENTER, PLLC | 912065379 - (WA) DIGESTIVE DISEASE & ENDOSCOPY CENTER, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $2499.00 | 1770731853 - SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER LENEXA | 364634843 - (KS) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $1800.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $3599.00 | 1730466483 - HOAG OUTPATIENT CENTERS, LLC, HOAG ENDOSCOPY CENTER | 453587572 - (CA) HOAG OUTPATIENT CENTERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $926.00 | 1255404398 - WARMINSTER AMBULATORY SURGICAL, BUXMONT AMBULATORY SURGICAL CENTER | 232779763 - (PA) WARMINSTER AMBULATORY SURGICAL | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $3807.00 | 1730834730 - HERITAGE DEVELOPMENT PARTNERS, LLC, ORTHOPAEDIC SURGERY CENTER | 882720151 - (KY) HERITAGE DEVELOPMENT PARTNERS LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $950.00 | 1124777321 - VIRGINIA CARDIOVASCULAR SPECIALISTS, VCS HEART AND VASCULAR CENTER | 541090122 - (VA) VIRGINIA CARDIOVASCULAR SPECIALISTS PC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $2859.00 | 1194351833 - DELRAY BEACH ASC, LLC, DELRAY BEACH SURGERY CENTER | 843067076 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $2388.00 | 1871804815 - GATEWAY SURGERY CENTER LLC | 272800486 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $1309.00 | 1548710775 - LINCOLN DIGESTIVE HEALTH CENTER LLC | 371833798 - (NE) LINCOLN DIGESTIVE HEALTH CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $825.00 | 1336605351 - KURESMART PAIN MANAGEMENT SURGERY CENTER, CLEARWAY SURGERY CENTER OF DUNDALK | 832407319 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $1175.00 | 1336104926 - ATLANTA SURGERY CENTER LTD | 742452953 - (GA) ATLANTA SURGERY CENTER LTD | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $2388.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52700 | $8705.00 | 1861657256 - INDIANA ENDOSCOPY CENTERS LLC | 208398421 | IN | 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 52700 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52700 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 52700 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52700. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52700 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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