Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 53866 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.
Cathj Rmvl Temp Dev Ischmc Rmdlg Bldr Neck&Prst8, Catheterization With Removal Of Temporary Device For Ischemic Remodeling (Ie Pressure Necrosis) Of Bladder Neck And Pro
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53866 |
| Medicaid Fee Schedule | View Medicaid rates for 53866 |
National average reimbursement for CPT 53866 by major payers:
$202.03
$198.13
$155.61
$143.98
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 53866.
CPT 53866
5 of 25 sample ratesHigher to lower in this preview
Memorial Ambulatory Surgery Center, LLC
Virtua-Memorial Hospital Burlington County Inc
$3,624.00Published rateAspen Surgery Center, LLC, Aspen Surgery Center
Aspen Surgery Center LLC
$905.00Published rateDenver West Endoscopy Center, LLC
Denver West Endoscopy Center LLC
$753.00Published rateFirst Street Surgery Center Inc.
First Street Surgery Center Inc
$450.00Published rateArizona Surgical Specialists Center, LLC, Arizona Surgical Specialists Center, LLC - Scottsdale
Arizona Surgical Specialists Center LLC
$105.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 53866 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53866 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 53866 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 |
|---|---|---|
| 53866-CPT | Moderate | Cathj Rmvl Temp Dev Ischmc Rmdlg Bldr Neck&Prst8, Catheterization With Removal Of Temporary Device For Ischemic Remodeling (Ie Pressure Necrosis) Of Bladder Neck And Pro |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53866. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53866 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 53866) and we'll show you how you compare in 15 minutes or less.