CPT 53410 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 51 - Multiple procedures |
| Complexity Level | High |
| CMS | $949.37 Physician Fee Schedule |
National average reimbursement for CPT 53410 by major payers:

$1,206.12

$1,317.04

$1,451.53

$1,635.76
| 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 53410 | ||||||
United | 53410 | $2483.00 | 1588619811 - LAWRENCEVILLE SURGERY CENTER, LLC | 582591488 - (GA) LAWRENCEVILLE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $1896.00 | 1699256404 - LEGACY SURGERY CENTER LLC | 831722822 - (FL) LEGACY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $971.00 | 1972147239 - CHILDREN'S SURGERY CENTER OF PHILADELPHIA LLC, CHILDREN'S DENTAL SURGERY OF PHILADELPHIA | 842886610 - (PA) CHILDRENS SURGERY CENTER OF PHILADELPHIA LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $7838.00 | 1952331092 - MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | 203233617 - (TX) MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $1130.00 | 1831217231 - THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | 205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $1950.00 | 1376709907 - ARDMORE REGIONAL SURGERY CENTER, LLC | 262814211 - (OK) ARDMORE REGIONAL SURGERY CENTER | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $3188.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $4339.00 | 1174073506 - WILSHIRE ENDOSCOPY CENTER LLC | 813966913 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $4527.00 | 1720161615 - MANKATO SURGICAL CENTER, L.L.C., MANKATO SURGERY CENTER | 411924647 - (MN) MANKATO SURGICAL CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $425.00 | 1578558078 - KINGSPORT ENDOSCOPY CORPORATION | 61249637 - (TN) KINGSPORT ENDOSCOPY CORPORATION | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $1200.00 | 1104998558 - AMERICAN EYE SURGERY CENTER, INC. | 203774302 - (GA) AMERICAN EYE SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $4467.00 | 1457960536 - LAKE GEORGE SURGERY CENTER, LLC | 844411548 - (IN) LAKE GEORGE SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $1689.00 | 1306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC | 510571797 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $1913.00 | 1528622321 - PREMIER-COVENANT ASTC LLC, PREMIER AMBULATORY SURGERY CENTER | 834550993 - (TN) PREMIERCOVENANT ASTC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53410 | $4992.00 | 1467920389 - KU MEDWEST AMBULATORY SURGERY CENTER, LLC | 20664568 - (KS) KU MEDWEST AMBULATORY SURGERY CENTER LLC | KS | 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 53410 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53410 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 53410 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 53410. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53410 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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