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See a sample rate comparisonCPT 53210 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.
Remove Urine Tract, Surgery To Remove The Urethra (Tube That Drains The Bladder) And To Create An Opening Between The Bladder And Skin For Drainage Of Urine.
| 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 52 - Reduced Services 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53210 |
| Medicaid Fee Schedule | View Medicaid rates for 53210 |
National average reimbursement for CPT 53210 by major payers:
$961.46
$1,043.95
$1,084.27
$1,265.20
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CPT 53210
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$9,270.00Published rateAnne Arundel-Sca Surgicenter, LLC, Aamc Surgery Center - Annapolis
Anne Arundelsca Surgicenter LLC
$3,428.00Published rateGramercy Surgery Center, Ltd
$2,675.00Published rateBarnet Dulaney Perkins Eye Center, PC, Bdpec Showlow
Barnet Dulaney Perkins Eye Center PLLC
$1,410.00Published rateAkstein Eye Center, Asc, Akstein Eye Center, Asc
Akstein Eye Center PC
$702.00Published rate
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See a sample payer proposalCPT 53210 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53210 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 53210 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 |
|---|---|---|
| 53200-CPT | Moderate | Biopsy Of Urethra |
| 53210-CPT | Moderate | Remove Urine Tract, Surgery To Remove The Urethra (Tube That Drains The Bladder) And To Create An Opening Between The Bladder And Skin For Drainage Of Urine. |
| 53220-CPT | Moderate | Exc/Fulgurate Urethra Carcinoma |
| 53230-CPT | Moderate | Excis Urethral Diverticulum;Female |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53210 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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