CPT 53505 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53505 |
National average reimbursement for CPT 53505 by major payers:

$636.05

$653.03

$676.98

$816.20
| 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 53505 | ||||||
United | 53505 | $484.92 | 1053356436 - EDGEWORTH COMMONS GROUP LLC, SURGERY CENTER AT EDGWORTH COMMONS | 20713415 - (PA) EDGEWORTH COMMONS GROUP LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $939.00 | 1912992900 - BOISE ENDOSCOPY CENTER, LLC, DBA MERIDIAN ENDOSCOPY CENTER | 820506078 - (ID) BOISE ENDOSCOPY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $2700.00 | 1528553831 - ORLANDO SURGERY CENTER, LLC, ORLANDO SURGERY CENTER | 821428367 - (FL) ORLANDO SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $1740.00 | 1346287232 - MODESTO SURGERY CENTER | 770394007 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $1398.00 | 1376580498 - SAME DAY SURGERY CENTERS OF FLORIDA LLC, SAME DAY SURGERY CENTER | 201804147 - (FL) SAME DAY SURGERY CENTERS OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $1175.00 | 1932298718 - OUTPATIENT SERVICES EAST | 630888861 - (AL) OUTPATIENT SERVICES EAST LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $897.00 | 1164734232 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC | 272910652 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $1998.00 | 1225458755 - AOS SURGERY CENTER LLC | 464197221 - (GA) AOS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $1665.00 | 1942261599 - SDOSC, LP, SAN DIEGO OUTPATIENT AMBULATORY SURGICAL CENTER | 30506487 - (CA) SDOSC, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $2800.00 | 1538280284 - PHYSICIANS SURGERY CENTER OF MODESTO INC, RIVER SURGICAL INSTITUTE | 201088433 - (CA) PHYSICIANS SURGERY CENTER OF MODESTO DBA RIVER SURGICAL INSTITUTE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $3623.00 | 1700887643 - MNH SURGICAL CENTER INC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $6941.00 | 1487012480 - LAKE SPIVEY AMBULATORY SURGERY CARE, LLC, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $4113.00 | 1740874031 - DOCTORS OUTPATIENT CENTER FOR SURGERY, LLC | 364928433 - (CA) DOCTORS OUTPATIENT CENTER FOR SURGERY LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $2435.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53505 | $3260.00 | 1619972791 - AMBULATORY SURGERY CENTER OF SPARTANBURG, LLC | 571128350 - (SC) AMBULATORY SURGERY CENTER OF SPARTANBURG | SC | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 53505 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53505 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 53505 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 53505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53505 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 53505) and we'll show you how you compare in 15 minutes or less.
