How much does Medicare pay for CPT 00873?

Medicare allowed an average of $129.00 per service and paid $101.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1326.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00873?

Anesthesia for shock wave therapy for urinary system stones without water bath. It was billed 8,064 times to 7,580 Medicare beneficiaries by 415 providers in 2024.

Does 00873 pay differently in an office than a hospital?

Yes. The allowed amount averaged $77.64 in an office setting and $129.15 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 00873 most?

Anesthesiology, with 4,367 services from 225 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Anesthesiology Assistant, Pain Management.

CPT 00873

Anesthesia for shock wave therapy for urinary system stones without water bath

$129.00Medicare-allowed amount per service, averaged across 8,064 services

Providers submitted

$1326.22

Asking price, not received

Medicare allowed

$129.00

The fee schedule figure

Medicare paid

$101.83

Balance is patient coinsurance

Providers submitted an average of $1326.22 for this code and Medicare allowed $129.00 — 10.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $101.83 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $77.64
Hospital / facility: $129.15

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 24 services were billed in an office setting and 8,040 in a facility.

Services: 8,064
Beneficiaries: 7,580
Providers billing it: 415
Total allowed: $1,040,256

What Medicare pays for CPT 00873

Across 8,064 services billed by 415 providers to 7,580 beneficiaries, Medicare allowed an average of $129.00 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 00873

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	4,367	4,140	$120.37	225
Certified Registered Nurse Anesthetist (CRNA)	3,499	3,246	$142.58	177
Anesthesiology Assistant	152	148	$79.01	11
Pain Management	46	46	$80.15	2

00873 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	876	$142.65	$105.86	29
Mississippi	657	$124.61	$103.61	34
South Carolina	613	$99.52	$80.23	29
Texas	474	$98.45	$78.41	27
Florida	471	$140.45	$108.43	20
Massachusetts	407	$103.69	$80.55	23
Kentucky	399	$136.36	$110.52	22
Oklahoma	393	$150.47	$121.64	17
Ohio	345	$148.99	$119.40	19
Pennsylvania	318	$83.19	$65.68	17
Virginia	310	$81.63	$65.57	13
Indiana	282	$113.08	$93.39	13
Maryland	280	$163.21	$124.12	16
Missouri	268	$146.82	$119.86	16
Georgia	237	$127.80	$102.13	15
California	228	$181.07	$140.09	13
New York	198	$143.14	$102.75	13
Illinois	160	$162.34	$120.28	9
North Carolina	140	$104.24	$82.05	7
Delaware	120	$153.48	$120.14	6
Tennessee	115	$143.18	$116.53	8
Arizona	109	$169.66	$133.73	6
Alabama	95	$83.84	$69.80	7
Michigan	89	$93.54	$69.80	6
Nebraska	76	$179.04	$146.26	5
Louisiana	57	$171.30	$138.95	3
Washington	57	$164.23	$126.50	4
Colorado	52	$197.56	$156.83	2
Utah	36	$168.63	$130.68	1
District of Columbia	26	$86.52	$72.04	2
Connecticut	25	$124.49	$93.98	2
Kansas	24	$126.28	$109.55	2
West Virginia	24	$85.26	$68.78	1
Puerto Rico	16	$190.29	$151.78	1
Montana	14	$110.98	$87.81	1
Rhode Island	14	$81.06	$61.52	1
Arkansas	13	$162.15	$125.71	1
Iowa	12	$74.17	$60.66	1
North Dakota	12	$170.46	$138.45	1
Wisconsin	11	$107.36	$86.47	1
Minnesota	11	$192.60	$155.36	1

Related codes

00811Anesthesia for other procedure on large bowel$99.16
00812Anesthesia for exam of colon$82.06
00813Anesthesia for procedure on small and large bowel$125.41
00840Anesthesia for other procedure on lower abdomen$197.81
00830Anesthesia for other repair of lower abdomen hernia (1 year or older)$137.91
00865Anesthesia for extensive removal of prostate$273.52
00860Anesthesia for other procedure on lower abdomen outside abdominal cavi$170.50
00862Anesthesia for procedure on upper urinary tubes or removal of kidney f$283.02
00880Anesthesia for other procedure on large blood vessel of lower abdomen$445.90

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.