This information is retrieved from CMS Website (https://www.cms.gov/). It is provided as a courtesy for illustration purposes only. This does not in any way guarantee actual payment. Your local insurers may pay under their own guidelines. Review all information with your medical billing professionals.
| Code | Short Description | 2019 | |
| 51726 | Complex Cystometrogram | Total Payment | $ 286.15 |
| Professional Interpretation | $ 88.66 | ||
| Technical Component | $ 197.49 | ||
| 51727 | Cystometrogram with UPP | Total Payment | $ 338.41 |
| Professional Interpretation | $ 110.28 | ||
| Technical Component | $ 228.13 | ||
| 51728 | Cystometrogram with Voiding Pressure | Total Payment | $ 344.17 |
| Professional Interpretation | $ 108.48 | ||
| Technical Component | $ 235.70 | ||
| 51729 | Cystometrogram with UPP and Voiding Pressure | Total Payment | $ 367.96 |
| Professional Interpretation | $ 130.82 | ||
| Technical Component | $ 237.14 | ||
| 51741 | Complex Uroflowmetry | Total Payment | $ 14.78 |
| Professional Interpretation | $ 8.65 | ||
| Technical Component | $ 6.13 | ||
| 51784 | Anal/urinary muscle study | Total Payment | $ 69.56 |
| Professional Interpretation | $ 38.92 | ||
| Technical Component | $ 30.63 | ||
| 51797 | Intraabdominal pressure test | Total Payment | $ 142.35 |
| Professional Interpretation | $ 41.81 | ||
| Technical Component | $ 100.55 | ||
| 51701 | Insert Bladder Catheter | Total Payment | $ 45.77 |
| 51798 | Ultrasound Bladder Capacity | Total Payment | $ 12.97 |
If Doctor Performs Complex CMG with Voiding Pressure Study, EMG and Uroflow
Total Reimbursement per Patient: $487.98
| PROCEDURE | CPT CODE | REIMBURSEMENT CALCULATION | FEE |
|---|---|---|---|
| Complex CMG with Voiding Pressure Study | 51728 | $327.60 @ 100% | $327.60 |
| Uroflow | 51741-51 | $16.15 @ 50% | $8.10 |
| EMG | 51784-51 | $71.28 @ 50% | $35.64 |
| Voiding Pressure Test | 51797* | $116.64 @ 100% | $116.64 |
If Doctor Performs Complex CMG with Voiding Pressure Study, Urethral Pressure Profile Study, EMG and Uroflow
Total Reimbursement per Patient: $512.10
| PROCEDURE | CPT CODE | REIMBURSEMENT CALCULATION | FEE |
|---|---|---|---|
| Complex CMG with Voiding Pressure Study & UPP | 51729 | $351.72 @ 100% | $351.72 |
| Uroflow | 51741-51 | $16.20 @ 50% | $8.10 |
| EMG | 51784-51 | $71.28 @ 50% | $35.64 |
| Voiding Pressure Test | 51797* | $116.64 @ 100% | $116.64 |
*Code 51797 can only be billed if also billing either 51728 or 51729. 51797 is not billed with a -51 modifier as it is an add-on code to 51728 or 51729.
| 51600 | Injection for Bladder X-ray | Total Payment | $ 200.74 |
| 74430 | Contrast X-ray, Bladder | Total Payment | $ 40.00 |
| Professional Interpretation | $ 16.58 | ||
| Technical Component | $ 23.43 | ||
| 74455 | X-ray, Urethra/Bladder | Total Payment | $ 91.90 |
| Professional Interpretation | $ 16.94 | ||
| Technical Component | $ 74.96 | ||
| 76000 | Fluoroscope Examination | Total Payment | $ 47.93 |
| Professional Interpretation | $ 15.86 | ||
| Technical Component | $ 32.07 |
| CODE | DESCRIPTION |
|---|---|
| N32.3 | Diverticulum of bladder / Diverticulitis of bladder |
| N32.81 | Overactive bladder |
| N35 | Urethral stricture |
| N36.1 | Urethral diverticulum |
| N36.4 | Urethral functional and muscular disorders |
| N36.42 | Intrinsic sphincter deficiency (ISD) |
| N36.44 | Muscular disorders of urethra |
| N39.0 | Urinary tract infection, site not specified |
| N39.3 | Stress incontinence; use additional code to identify overactive bladder or detrusor muscle hyperactivity |
| N39.41 | Urge incontinence |
| N39.44 | Nocturnal enuresis |
| N39.46 | Mixed incontinence |
| N40.1 | Enlarged prostate with lower urinary tract symptoms (LUTS) |
| R33 | Retention of urine |
| R35 | Polyuria, Frequency of micturition, Nocturia |
| R35.0 | Urinary frequency |
| R35.1 | Nocturia |
| R39.11 | Hesitancy of micturition |
| R39.12 | Poor urinary stream |
| R39.14 | Feeling of incomplete bladder emptying |
| R39.15 | Urgency of urination |
| R39.16 | Straining to void |
| R39.81 | Functional urinary incontinence |
| K59 | Other functional intestinal disorders |
| K59.0 | Constipation |
| K59.1 | Functional diarrhea |
| K59.2 | Neurogenic bowel, not elsewhere classified |
| K59.3 | Megacolon, not elsewhere classified |
| K59.8 | Other specified functional intestinal disorders |
| K59.9 | Functional intestinal disorder, unspecified |
| K60 | Fissure and fistula of anal and rectal regions |
| K62.9 | Disease of anus and rectum, unspecified |
| K59 | Other functional intestinal disorders |
| CODE | DESCRIPTION |
|---|---|
| K21.0 | Gastro-esophageal reflux disease with esophagitis |
| K21.9 | Gastro-esophageal reflux disease without esophagitis |
| K22.0 | Achalasia of cardia |
| K30 | Functional dyspepsia |
| K52.2 | Allergic and dietetic gastroenteritis and colitis |
| K52.89 | Other specified noninfective gastroenteritis and colitis |
| R11.0 | Nausea |
| R11.10 | Vomiting, unspecified |
| R11.11 | Vomiting without nausea |
| R11.12 | Projectile vomiting |
| R11.13 | Vomiting of fecal matter |
| R11.14 | Bilious vomiting |
| R11.2 | Nausea with vomiting, unspecified |
| R12 | Heartburn |
| R13.0 | Aphagia |
| R13.10 | Dysphagia, unspecified |
| R13.11 | Dysphagia, oral phase |
| R13.12 | Dysphagia, oropharyngeal phase |
| R13.13 | Dysphagia, pharyngeal phase |
| R13.14 | Dysphagia, pharyngoesophageal phase |
| R13.19 | Other dysphagia |
| R14.0 | Abdominal distension (gaseous) |
| R14.1 | Gas pain |
| R14.2 | Eructation |
| R14.3 | Flatulence |
| R15.0 | Incomplete defecation |
| R15.1 | Fecal smearing |
| R15.2 | Fecal urgency |
| R15.9 | Full incontinence of feces |
| R19.11 | Absent bowel sounds |
| R19.12 | Hyperactive bowel sounds |
| R19.15 | Other abnormal bowel sounds |
| R19.2 | Visible peristalsis |
| R19.4 | Change in bowel habit |
| R19.5 | Other fecal abnormalities |
| R19.7 | Diarrhea, unspecified |
| R19.8 | Other specified symptoms and signs |
You deserve the best care possible along your way to leading a more normal life, and Laborie offers diagnostic and therapeutic options along the treatment pathway.