Reimbursement Information

The following Medicare reimbursement data is for reference purposes only and is based on the Medicare Physician Fee Schedule as of September 21, 2021. Gemini Medical Technologies assumes no responsibility for its accuracy.

This information is not specific to your MAC Locality or 3rd Party Insurer Fee Schedule. Actual Payment may vary. Review all billing and coding with medical billing professionals.

Reimbursement by Location

Find out the reimbursement amounts for various procedures in your region.

Reimbursement Codes Based on Medicare National Averages

CPT CODE PROCEDURE Professional Technical Global
CPT CODE
51726
PROCEDURE
Complex cystometrogram
Professional
$85.84
Technical
$228.90
Global
$314.74
CPT CODE
51727
PROCEDURE
Cystometrogram with UPP
Professional
$107.47
Technical
$271.12
Global
$378.59
CPT CODE
51728
PROCEDURE
Cystometrogram with Voiding Pressure
Professional
$105.03
Technical
$277.05
Global
$382.08
CPT CODE
51729
PROCEDURE
Cystometrogram with UPP and Voiding Pressure
Professional
$128.06
Technical
$277.40
Global
$405.46
CPT CODE
51741
PROCEDURE
Electro-uroflowmetry first
Professional
$8.72
Technical
$5.58
Global
$14.31
CPT CODE
51784
PROCEDURE
Anal/urinary muscle study
Professional
$37.69
Technical
$29.66
Global
$67.34
CPT CODE
51797
PROCEDURE
Intraabdominal pressure test
Professional
$39.78
Technical
$152.83
Global
$192.61
CPT CODE
51701
PROCEDURE
Insert Bladder Catheter
Professional
NA
Technical
NA
Global
$46.76
CPT CODE
51798
PROCEDURE
Ultrasound Bladder Capacity
Professional
NA
Technical
NA
Global
$10.47

Procedure Reimbursement Codes Based on Medicare National Averages

Complex CMG with EMG and Uroflow

CPT CODE MODIFIER Procedure Reimbursement Allowable Fee
CPT CODE
51726
MODIFIER
Procedure
Complex cystometrogram
Reimbursement
$314.74
Allowable
100%
Fee
$314.74
CPT CODE
51741
MODIFIER
-51
Procedure
Electro-uroflowmetry first
Reimbursement
$14.31
Allowable
50%
Fee
$7.15
CPT CODE
51784
MODIFIER
-51
Procedure
Anal / urinary muscle study (EMG)
Reimbursement
$67.34
Allowable
50%
Fee
$33.67
CPT CODE
Total Reimbursement per Patient:
MODIFIER
$355.56

Complex CMG with Urethral Pressure Profile Study, EMG and Uroflow

CPT CODE MODIFIER Procedure Reimbursement Allowable Fee
CPT CODE
51727
MODIFIER
Procedure
Cystometrogram with UPP
Reimbursement
$378.59
Allowable
100%
Fee
$378.59
CPT CODE
51741
MODIFIER
-51
Procedure
Electro-uroflowmetry first
Reimbursement
$14.31
Allowable
50%
Fee
$7.15
CPT CODE
51784
MODIFIER
-51
Procedure
Anal / urinary muscle study (EMG)
Reimbursement
$67.34
Allowable
50%
Fee
$33.67
CPT CODE
Total Reimbursement per Patient:
MODIFIER
$419.41

Complex CMG with Voiding Pressure Study, EMG and Uroflow

CPT CODE MODIFIER Procedure Reimbursement Allowable Fee
CPT CODE
51728
MODIFIER
Procedure
Complex cystometrogram
Reimbursement
$382.08
Allowable
100%
Fee
$382.08
CPT CODE
51741
MODIFIER
-51
Procedure
Complex Uroflowmetry
Reimbursement
$14.31
Allowable
50%
Fee
$7.15
CPT CODE
51784
MODIFIER
-51
Procedure
Anal / urinary muscle study (EMG)
Reimbursement
$67.34
Allowable
50%
Fee
$33.67
CPT CODE
51797*
MODIFIER
Procedure
Intraabdominal pressure test
Reimbursement
$192.61
Allowable
100%
Fee
$192.61
CPT CODE
Total Reimbursement per Patient:
MODIFIER
$615.51

Complex CMG with Voiding Pressure Study, Urethral Pressure Profile Study, EMG and Uroflow

CPT CODE MODIFIER Procedure Reimbursement Allowable Fee
CPT CODE
51729
MODIFIER
Procedure
Cystometrogram with UPP and Voiding Pressure
Reimbursement
$405.46
Allowable
100%
Fee
$405.46
CPT CODE
51741
MODIFIER
-51
Procedure
Complex Uroflowmetry
Reimbursement
$14.31
Allowable
50%
Fee
$7.15
CPT CODE
51784
MODIFIER
-51
Procedure
Anal / urinary muscle study (EMG)
Reimbursement
$67.34
Allowable
50%
Fee
$33.67
CPT CODE
51797*
MODIFIER
Procedure
Intraabdominal pressure test
Reimbursement
$192.61
Allowable
100%
Fee
$192.61
CPT CODE
Total Reimbursement per Patient:
MODIFIER
$638.89

*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.