How much does Medicare pay for CPT 51703?

Medicare allowed an average of $133.52 per service and paid $102.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $413.49, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 51703?

Complicated insertion of bladder tube. It was billed 20,180 times to 10,542 Medicare beneficiaries by 535 providers in 2024.

Does 51703 pay differently in an office than a hospital?

Yes. The allowed amount averaged $149.51 in an office setting and $72.08 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 51703 most?

Urology, with 15,065 services from 357 clinicians. Next are Nurse Practitioner, Physician Assistant, General Surgery.

CPT 51703

Complicated insertion of bladder tube

$133.52Medicare-allowed amount per service, averaged across 20,180 services

Providers submitted

$413.49

Asking price, not received

Medicare allowed

$133.52

The fee schedule figure

Medicare paid

$102.66

Balance is patient coinsurance

Providers submitted an average of $413.49 for this code and Medicare allowed $133.52 — 3.1× 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 $102.66 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $149.51
Hospital / facility: $72.08

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. 16,012 services were billed in an office setting and 4,168 in a facility.

Services: 20,180
Beneficiaries: 10,542
Providers billing it: 535
Total allowed: $2,694,434

What Medicare pays for CPT 51703

Across 20,180 services billed by 535 providers to 10,542 beneficiaries, Medicare allowed an average of $133.52 per service. That is 1.9 services per beneficiary, so this is a code patients typically receive more than once. 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 51703

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	15,065	7,236	$143.69	357
Nurse Practitioner	2,656	1,516	$107.14	88
Physician Assistant	2,366	1,705	$100.79	85
General Surgery	25	24	$39.11	1
Family Practice	24	17	$103.02	1
Diagnostic Radiology	18	18	$84.61	1
Certified Clinical Nurse Specialist	14	14	$63.27	1
Osteopathic Manipulative Medicine	12	12	$68.82	1

51703 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	3,088	$142.51	$93.21	81
California	2,802	$140.05	$97.68	67
Florida	2,730	$139.12	$103.95	43
Maryland	1,725	$129.46	$93.03	46
New Jersey	1,659	$130.89	$90.93	46
Massachusetts	913	$145.20	$100.79	21
Arizona	682	$121.76	$96.21	20
Illinois	639	$135.18	$98.82	20
Texas	559	$110.28	$87.43	19
North Carolina	479	$120.70	$93.83	20
Virginia	425	$132.74	$101.30	10
New Hampshire	419	$143.60	$105.33	11
Ohio	412	$130.23	$99.83	15
Georgia	367	$123.83	$90.97	11
Missouri	306	$112.96	$95.34	7
Colorado	300	$135.96	$103.25	10
U.S. Virgin Islands	242	$147.22	$107.69	1
Washington	179	$109.11	$80.12	5
Alaska	179	$152.22	$95.63	4
Pennsylvania	163	$103.04	$70.22	10
South Carolina	158	$129.33	$106.59	6
Delaware	154	$131.58	$93.14	7
Iowa	152	$79.72	$60.31	6
Indiana	151	$108.08	$91.84	7
Rhode Island	142	$150.42	$111.77	3
Michigan	132	$137.89	$111.64	4
Wisconsin	115	$122.81	$97.15	2
Kentucky	114	$122.83	$92.00	5
Arkansas	107	$85.27	$71.90	3
Oklahoma	91	$99.45	$85.14	2
District of Columbia	87	$133.45	$85.35	5
Connecticut	75	$139.95	$102.80	2
New Mexico	74	$139.13	$101.48	1
Mississippi	72	$121.71	$110.34	1
Alabama	55	$132.36	$112.23	2
Utah	53	$128.67	$109.02	2
Nevada	47	$104.16	$95.80	3
Idaho	39	$116.37	$88.43	2
Hawaii	33	$157.57	$112.74	1
Tennessee	19	$134.24	$105.72	1
Nebraska	17	$57.96	$47.13	1
Kansas	13	$60.88	$47.95	1
Minnesota	12	$62.67	$47.91	1

Related codes

51798Ultrasound measurement of bladder capacity after voiding$11.33
51741Electronic assessment of bladder emptying$10.90
51702Simple insertion of temporary bladder tube$56.08
51700Simple bladder irrigation and/or instillation$62.89
51784Non-needle measurement and recording of electrical activity of muscles$32.26
51701Insertion of temporary bladder tube$41.58
51797Insertion of device into abdomen$155.21
51720Instillation of anti-cancer drug into bladder$79.02
51728Complex measurement of pressure of urine flow in bladder$308.93
51705Simple change of bladder tube$86.83
51729Complex measurement of pressure of urine flow in bladder$338.91
51725Simple measurement of pressure of urine flow in bladder$165.67

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.