How much does Medicare pay for CPT 50081?

Medicare allowed an average of $1325.30 per service and paid $1054.09 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $6312.10, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 50081?

Complex surgical treatment of kidney stone with imaging guidance. It was billed 2,541 times to 2,327 Medicare beneficiaries by 113 providers in 2024.

Which specialty bills 50081 most?

Urology, with 2,333 services from 109 clinicians. Next are Ambulatory Surgical Center, Internal Medicine.

CPT 50081

Complex surgical treatment of kidney stone with imaging guidance

$1325.30Medicare-allowed amount per service, averaged across 2,541 services

Providers submitted

$6312.10

Asking price, not received

Medicare allowed

$1325.30

The fee schedule figure

Medicare paid

$1054.09

Balance is patient coinsurance

Providers submitted an average of $6312.10 for this code and Medicare allowed $1325.30 — 4.8× 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 $1054.09 (80%); the rest is the patient’s coinsurance and deductible.

Services: 2,541
Beneficiaries: 2,327
Providers billing it: 113
Total allowed: $3,367,587

What Medicare pays for CPT 50081

Across 2,541 services billed by 113 providers to 2,327 beneficiaries, Medicare allowed an average of $1325.30 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 50081

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	2,333	2,140	$1099.65	109
Ambulatory Surgical Center	175	158	$4374.36	3
Internal Medicine	33	29	$1108.30	1

50081 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
Maryland	544	$2011.96	$1585.24	10
New York	346	$1249.36	$864.46	11
California	272	$952.38	$717.65	13
Ohio	152	$1084.71	$876.75	9
Texas	127	$1087.48	$865.19	7
Indiana	119	$976.03	$826.12	7
Illinois	113	$1164.63	$896.38	6
Pennsylvania	77	$1117.82	$863.80	5
Virginia	68	$1050.54	$861.43	4
Florida	64	$1160.14	$883.83	4
North Carolina	59	$1035.77	$861.51	4
Colorado	51	$2429.29	$1913.87	2
District of Columbia	47	$1284.27	$864.67	1
Minnesota	44	$1148.57	$912.37	3
Michigan	43	$1195.99	$898.03	2
Kansas	39	$1052.03	$864.17	2
Massachusetts	37	$1178.08	$871.55	1
Tennessee	37	$999.79	$871.96	3
South Carolina	34	$1117.20	$898.09	2
Washington	32	$1161.33	$882.66	2
New Jersey	28	$1228.54	$885.22	2
Oklahoma	27	$1082.82	$876.66	2
Utah	20	$1075.61	$853.86	1
Arizona	20	$1076.89	$871.27	1
New Hampshire	20	$1037.98	$875.47	1
Alabama	19	$1005.52	$858.12	1
Iowa	19	$1018.02	$869.69	1
Kentucky	18	$1002.50	$873.65	1
Oregon	15	$1051.22	$868.91	1
Georgia	14	$1135.04	$868.62	1
Wisconsin	13	$1014.53	$868.32	1
Missouri	12	$1167.43	$942.45	1
West Virginia	11	$1125.60	$835.90	1

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.