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See a sample rate comparisonCPT 53085 Fee Schedule
Last Verified: October 2026
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.
Drain Excess Urine From Tissue, Surgery To Drain Urine That Has Passed Out Of The Urinary Tract Into The Surrounding Tissue.
| 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 GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53085 |
| Medicaid Fee Schedule | View Medicaid rates for 53085 |
National average reimbursement for CPT 53085 by major payers:
$800.16
$880.66
$905.90
$1,068.30
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CPT 53085
5 of 25 sample ratesHigher to lower in this preview
Oregon Outpatient Surgery Center LLC
$2,877.00Published rateShoreline Surgery Center LLP, Christus Spohn-Surgicare Of Corpus Christi
$2,353.00Published ratePony Creek Annex, LLC
Pony Creek Annex LLC
$1,868.00Published rateCarillon Surgery Center LLC
$1,291.00Published rateAlliance Surgery Center At Augusta, LLC
Alliance Surgery Center At Augusta LLC
$900.00Published rate
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See a sample payer proposalCPT 53085 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53085 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 53085 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 |
|---|---|---|
| 53040-CPT | Moderate | Drain Urine Tract Infection, Surgery To Drain An Abscess (Pocket Of Pus) In The Urinary Tract. The Abscess Is The Result Of An Infection Or Injury. |
| 53060-CPT | Moderate | Drain Urine Tract Infection, Surgery To Drain An Abscess (Pocket Of Pus) In The Urinary Tract. The Abscess Is The Result Of An Infection Or Injury. |
| 53080-CPT | Moderate | Drain Of Perineal Urinary Extravasation; Uncomplicated (Sepa Pr, Drainage Of Perineal Urinary Extravasation; Uncomplicated (Separate Pr |
| 53085-CPT | Moderate | Drain Excess Urine From Tissue, Surgery To Drain Urine That Has Passed Out Of The Urinary Tract Into The Surrounding Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53085. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53085 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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