How much does Medicare pay for CPT 51610?

Medicare allowed an average of $56.34 per service and paid $43.30 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $462.39, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 51610?

Injection procedure through bladder and urethra for x-ray imaging. It was billed 1,070 times to 962 Medicare beneficiaries by 51 providers in 2024.

Does 51610 pay differently in an office than a hospital?

Yes. The allowed amount averaged $103.11 in an office setting and $43.67 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 51610 most?

Urology, with 925 services from 43 clinicians. Next are Diagnostic Radiology, Radiation Oncology, Physician Assistant.

CPT 51610

Injection procedure through bladder and urethra for x-ray imaging

$56.34Medicare-allowed amount per service, averaged across 1,070 services

Providers submitted

$462.39

Asking price, not received

Medicare allowed

$56.34

The fee schedule figure

Medicare paid

$43.30

Balance is patient coinsurance

Providers submitted an average of $462.39 for this code and Medicare allowed $56.34 — 8.2× 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 $43.30 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $103.11
Hospital / facility: $43.67

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. 228 services were billed in an office setting and 842 in a facility.

Services: 1,070
Beneficiaries: 962
Providers billing it: 51
Total allowed: $60,284

What Medicare pays for CPT 51610

Across 1,070 services billed by 51 providers to 962 beneficiaries, Medicare allowed an average of $56.34 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 51610

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	925	828	$56.33	43
Diagnostic Radiology	94	84	$62.01	5
Radiation Oncology	32	32	$40.90	2
Physician Assistant	19	18	$54.71	1

51610 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
Georgia	113	$31.52	$24.84	1
California	76	$48.10	$33.45	4
Pennsylvania	75	$50.65	$37.30	5
Texas	65	$53.94	$46.23	3
Oregon	61	$35.87	$27.34	4
Arizona	58	$80.29	$62.97	3
Massachusetts	51	$62.92	$45.48	1
Maryland	51	$35.24	$27.67	2
Florida	51	$36.62	$25.83	1
New York	47	$71.57	$49.32	3
Colorado	47	$63.71	$42.33	1
Virginia	45	$114.80	$85.58	2
Illinois	38	$119.67	$80.84	2
Michigan	34	$61.51	$43.89	2
Kansas	27	$44.84	$33.47	2
Ohio	27	$44.72	$37.05	2
Idaho	24	$42.79	$36.69	2
North Carolina	23	$92.41	$61.29	1
Connecticut	20	$46.49	$32.36	1
Wyoming	19	$30.66	$24.84	1
Wisconsin	19	$43.27	$31.65	1
Missouri	18	$32.26	$26.19	1
Minnesota	16	$98.15	$69.14	1
Washington	14	$31.43	$24.86	1
Mississippi	14	$113.90	$102.41	1
Nevada	13	$30.85	$24.89	1
Tennessee	13	$58.02	$28.57	1
Alabama	11	$57.46	$47.39	1

Related codes

51600Injection procedure for imaging of bladder during voiding$85.27

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.