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See a sample rate comparisonCPT 53200 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.
Biopsy Of Urethra
| 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 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53200 |
| Medicaid Fee Schedule | View Medicaid rates for 53200 |
National average reimbursement for CPT 53200 by major payers:
$212.67
$215.04
$225.32
$235.23
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CPT 53200
5 of 25 sample ratesHigher to lower in this preview
Surgcenter Of St. Lucie, LLC
$2,353.00Published rateColiseum Same Day Surgery Center Lp
$1,414.00Published rateEye Laser & Surgery Center Of Columbus, LLC
Eye Laser Surgery Center Of Columbus LLC
$984.00Published rateSound Surgeons PLLC, Northwest Weight Loss Surgery
Sound Surgeons, PLLC
$443.00Published rateSan Diego Endoscopy Center
$425.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 53200 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53200 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 53200 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 |
|---|---|---|
| 53000-CPT | Low | Urethrotomy Or Urethrostomy Xtrnal (Sepa Proc); Pendulous, Urethrotomy Or Urethrostomy External (Separate Procedure); Pendulous |
| 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. |
| 53200-CPT | Moderate | Biopsy Of Urethra |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53200 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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