How much does Medicare pay for CPT 50200?

Medicare allowed an average of $128.67 per service and paid $99.77 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1312.14, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 50200?

Needle biopsy of kidney. It was billed 11,956 times to 11,596 Medicare beneficiaries by 634 providers in 2024.

Does 50200 pay differently in an office than a hospital?

Yes. The allowed amount averaged $447.65 in an office setting and $119.65 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 50200 most?

Diagnostic Radiology, with 6,525 services from 347 clinicians. Next are Interventional Radiology, Nephrology, Internal Medicine.

CPT 50200

Needle biopsy of kidney

$128.67Medicare-allowed amount per service, averaged across 11,956 services

Providers submitted

$1312.14

Asking price, not received

Medicare allowed

$128.67

The fee schedule figure

Medicare paid

$99.77

Balance is patient coinsurance

Providers submitted an average of $1312.14 for this code and Medicare allowed $128.67 — 10.2× 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 $99.77 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $447.65
Hospital / facility: $119.65

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 329 services were billed in an office setting and 11,627 in a facility.

Services: 11,956
Beneficiaries: 11,596
Providers billing it: 634
Total allowed: $1,538,379

What Medicare pays for CPT 50200

Across 11,956 services billed by 634 providers to 11,596 beneficiaries, Medicare allowed an average of $128.67 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 50200

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	6,525	6,411	$120.42	347
Interventional Radiology	2,823	2,768	$121.73	172
Nephrology	1,853	1,710	$163.81	78
Internal Medicine	176	160	$119.67	7
Urology	155	151	$116.93	6
General Surgery	150	134	$221.69	8
Physician Assistant	145	140	$101.49	9
Undefined Physician type	36	35	$123.78	1
Radiation Oncology	28	28	$106.55	1
Nurse Practitioner	26	22	$101.23	2
Vascular Surgery	16	15	$92.19	1
Nuclear Medicine	12	11	$121.59	1
Ambulatory Surgical Center	11	11	$483.16	1

50200 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
California	1,075	$135.93	$97.88	63
Texas	893	$117.12	$92.20	55
New York	872	$208.94	$146.91	48
Florida	865	$139.26	$105.16	32
Arizona	748	$117.21	$88.95	22
Minnesota	743	$119.09	$91.16	30
Illinois	657	$136.71	$96.85	29
Maryland	512	$125.94	$93.13	23
Ohio	481	$114.55	$88.26	28
Pennsylvania	436	$117.43	$91.30	25
Virginia	368	$116.55	$90.08	20
Massachusetts	342	$144.92	$105.23	22
Tennessee	328	$113.42	$93.91	19
Wisconsin	311	$115.23	$92.15	15
Georgia	258	$110.59	$88.36	16
Missouri	245	$110.77	$88.96	15
Michigan	219	$121.23	$91.24	10
Washington	203	$119.78	$91.30	13
Iowa	201	$107.92	$88.41	11
South Carolina	201	$111.03	$90.04	11
New Jersey	186	$128.91	$95.02	9
North Carolina	168	$110.15	$88.51	13
Oklahoma	156	$110.41	$86.67	9
Arkansas	150	$137.28	$117.33	10
Louisiana	146	$115.98	$89.85	9
Alabama	132	$110.17	$89.28	7
Nebraska	111	$105.34	$87.88	7
Connecticut	107	$126.95	$91.68	4
Mississippi	86	$112.83	$96.44	6
Oregon	74	$111.37	$83.98	6
North Dakota	72	$102.01	$84.48	5
Kentucky	60	$121.26	$96.84	4
Delaware	57	$123.18	$97.16	3
Indiana	57	$113.35	$96.43	3
Idaho	51	$105.13	$83.00	4
Kansas	50	$113.79	$91.09	4
Vermont	49	$115.13	$92.93	4
Utah	42	$111.58	$91.44	3
Rhode Island	42	$105.95	$77.45	2
Nevada	38	$114.23	$91.80	3
District of Columbia	38	$128.93	$91.77	3
New Hampshire	34	$109.43	$83.29	2
Colorado	27	$118.57	$99.80	2
West Virginia	26	$111.57	$87.44	2
Wyoming	15	$111.74	$84.11	1
South Dakota	13	$107.55	$89.49	1
New Mexico	11	$108.45	$79.23	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.