CPT 53270 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| CMS | $208.31 Physician Fee Schedule |
National average reimbursement for CPT 53270 by major payers:

$264.36

$281.82

$300.76

$353.37
| 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 53270 | ||||||
United | 53270 | $1821.00 | 1760931349 - SF NASSAU ASC LLC | 300870382 - (NY) SF NASSAU ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $1801.00 | 1962431197 - SHAWNEE MISSION SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER SHAWNEE MISSION | 481243914 - (KS) SHAWNEE MISSION SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $775.00 | 1649250218 - LORAIN SURGERY CENTER, LLC | 201641777 - (OH) LORAIN SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $1650.00 | 1538722699 - R & R SURGICAL CENTERS | 820815470 - (CA) RR SURGICAL INSTITUTE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $2289.00 | 1710615869 - ORTHOILLINOIS SURGERY CENTER ELGIN, LLC | 851212739 - (IL) ORTHOILLINOIS SURGERY CENTER ELGIN LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $800.00 | 1356901995 - CASE CENTER FOR SURGERY & ENDOSCOPY LLC | 833509420 - (OH) CASE, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $4074.00 | 1164486809 - SAINT LUKE'S SURGICENTER | 470853481 - (MO) SAINT LUKES SURGICENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $2388.00 | 1861905176 - BERKSHIRE EYE, LLC | 352609003 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $1295.00 | 1427355080 - PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC, PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC | 272900107 - (GA) PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $1460.00 | 1518149954 - NEUROLOGICAL INSTITUTE AMBULATORY SURGICAL CENTER, LLC | 141983013 - (GA) NEUROLOGICAL INSTITUTE AMBULATORY SURGICAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $915.00 | 1265455463 - THE ENDOSCOPY CENTER AT BEL AIR | 470863243 - (MD) THE ENDOSCOPY CENTER AT BEL AIR | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $475.00 | 1356311419 - RIVERSIDE AMBULATORY SURGERY CENTER LLC | 522233625 - (MD) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $2388.00 | 1396174454 - SURGERY CENTER OF SCOTTSDALE LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $2388.00 | 1700887643 - MNH SURGICAL CENTER INC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53270 | $1485.00 | 1124283510 - WILLS EYE SURGERY CENTER | 510385184 - (DE) WILMINGTON AMBULATORY SURGICAL CENTER LLC | DE | 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 53270 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53270 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 53270 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 53270. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53270 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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