How much does Medicare pay for CPT 50543?

Medicare allowed an average of $1239.99 per service and paid $987.58 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5596.59, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 50543?

Partial removal of kidney using an endoscope. It was billed 1,816 times to 1,800 Medicare beneficiaries by 119 providers in 2024.

Which specialty bills 50543 most?

Urology, with 1,525 services from 101 clinicians. Next are Physician Assistant, Nurse Practitioner, Certified Clinical Nurse Specialist.

CPT 50543

Partial removal of kidney using an endoscope

$1239.99Medicare-allowed amount per service, averaged across 1,816 services

Providers submitted

$5596.59

Asking price, not received

Medicare allowed

$1239.99

The fee schedule figure

Medicare paid

$987.58

Balance is patient coinsurance

Providers submitted an average of $5596.59 for this code and Medicare allowed $1239.99 — 4.5× 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 $987.58 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,816
Beneficiaries: 1,800
Providers billing it: 119
Total allowed: $2,251,822

What Medicare pays for CPT 50543

Across 1,816 services billed by 119 providers to 1,800 beneficiaries, Medicare allowed an average of $1239.99 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 50543

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	1,525	1,512	$1424.95	101
Physician Assistant	229	228	$204.19	14
Nurse Practitioner	26	26	$194.53	2
Certified Clinical Nurse Specialist	21	19	$187.63	1
General Surgery	15	15	$1534.99	1

50543 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 York	250	$1251.52	$883.79	13
Florida	144	$1219.74	$908.77	9
California	134	$1289.91	$957.46	10
New Jersey	104	$1087.65	$778.54	6
Texas	100	$1316.15	$1015.07	6
Massachusetts	89	$1558.07	$1139.13	5
Ohio	79	$1224.96	$998.49	6
Pennsylvania	75	$1507.24	$1150.70	5
Indiana	74	$1319.44	$1101.40	6
Tennessee	74	$1083.02	$921.11	4
Virginia	62	$1384.92	$1126.57	5
Oklahoma	60	$950.19	$801.67	3
Washington	56	$980.97	$756.51	3
Kansas	49	$473.58	$397.02	3
North Carolina	48	$1094.35	$937.37	3
Arkansas	43	$1300.03	$1142.84	3
South Carolina	40	$1411.30	$1138.32	3
Georgia	38	$1467.40	$1155.50	3
District of Columbia	37	$1565.16	$1131.83	3
Maryland	35	$1537.63	$1143.57	2
Michigan	27	$1459.63	$1145.39	2
Missouri	25	$1327.62	$1109.23	2
Alabama	24	$182.20	$149.94	2
Arizona	23	$1426.16	$1152.87	2
Mississippi	23	$1227.19	$1071.91	2
Wisconsin	22	$782.39	$666.12	2
Delaware	17	$1561.97	$1154.23	1
Minnesota	14	$1505.64	$1155.33	1
Oregon	14	$1529.96	$1147.83	1
Colorado	13	$1273.89	$1001.44	1
Iowa	12	$778.27	$655.48	1
Illinois	11	$1445.88	$1150.19	1

Related codes

50590Shock wave crushing of kidney stones$797.04

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.