How much does Medicare pay for CPT 51720?

Medicare allowed an average of $79.02 per service and paid $60.88 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $408.50, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 51720?

Instillation of anti-cancer drug into bladder. It was billed 79,780 times to 28,576 Medicare beneficiaries by 1,397 providers in 2024.

Does 51720 pay differently in an office than a hospital?

Yes. The allowed amount averaged $84.39 in an office setting and $35.58 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 51720 most?

Urology, with 53,912 services from 1,005 clinicians. Next are Nurse Practitioner, Physician Assistant, Hematology-Oncology.

CPT 51720

Instillation of anti-cancer drug into bladder

$79.02Medicare-allowed amount per service, averaged across 79,780 services

Providers submitted

$408.50

Asking price, not received

Medicare allowed

$79.02

The fee schedule figure

Medicare paid

$60.88

Balance is patient coinsurance

Providers submitted an average of $408.50 for this code and Medicare allowed $79.02 — 5.2× 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 $60.88 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $84.39
Hospital / facility: $35.58

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. 70,988 services were billed in an office setting and 8,792 in a facility.

Services: 79,780
Beneficiaries: 28,576
Providers billing it: 1,397
Total allowed: $6,304,216

What Medicare pays for CPT 51720

Across 79,780 services billed by 1,397 providers to 28,576 beneficiaries, Medicare allowed an average of $79.02 per service. That is 2.8 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 51720

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	53,912	19,412	$85.48	1,005
Nurse Practitioner	12,525	4,057	$62.04	159
Physician Assistant	10,238	3,656	$64.98	161
Hematology-Oncology	1,746	710	$92.87	34
Medical Oncology	453	271	$86.31	12
Ambulatory Surgical Center	290	231	$33.75	13
Certified Clinical Nurse Specialist	197	38	$70.36	1
Internal Medicine	106	59	$84.24	3
Family Practice	98	27	$63.74	2
Infectious Disease	79	43	$82.33	2
General Surgery	54	31	$36.90	2
Osteopathic Manipulative Medicine	47	16	$35.90	1
Obstetrics & Gynecology	21	12	$89.30	1
Radiation Oncology	14	13	$77.60	1

51720 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
Florida	8,927	$83.91	$62.89	130
California	7,462	$85.97	$58.51	108
New York	5,158	$86.28	$58.63	83
Massachusetts	4,113	$84.25	$58.92	56
Illinois	3,913	$86.46	$64.11	55
Pennsylvania	3,700	$80.74	$62.27	66
Maryland	3,608	$85.42	$61.90	73
Texas	3,401	$80.66	$61.08	63
Virginia	3,231	$82.60	$62.43	54
Arizona	2,693	$80.28	$63.09	50
Iowa	2,382	$47.04	$38.23	32
Washington	2,200	$67.98	$50.49	39
North Carolina	2,095	$74.17	$59.66	37
New Jersey	2,038	$92.41	$64.36	36
Tennessee	1,783	$54.44	$44.50	20
South Carolina	1,734	$74.76	$59.47	39
Michigan	1,719	$74.42	$56.91	36
Georgia	1,690	$79.88	$62.13	27
Missouri	1,550	$74.26	$60.04	23
Colorado	1,405	$75.53	$55.47	40
Ohio	1,398	$77.45	$62.01	26
Indiana	1,373	$78.55	$64.84	27
Oklahoma	1,089	$73.36	$58.77	26
Minnesota	907	$87.36	$65.92	35
Kentucky	830	$45.22	$35.89	10
Arkansas	800	$68.76	$59.37	14
Oregon	755	$83.90	$64.71	19
Delaware	737	$80.57	$59.63	15
New Hampshire	636	$67.76	$50.58	15
Nebraska	607	$72.12	$60.11	13
Idaho	603	$53.88	$45.07	15
Kansas	574	$77.05	$65.53	14
Louisiana	486	$73.69	$59.52	4
Rhode Island	451	$82.71	$61.80	8
South Dakota	439	$72.03	$56.84	13
Mississippi	424	$78.58	$64.49	6
Nevada	395	$76.22	$58.24	11
Wisconsin	380	$75.70	$61.94	12
District of Columbia	356	$71.61	$49.09	5
Connecticut	354	$94.23	$64.86	9
Alabama	336	$73.53	$60.95	8
Montana	291	$65.34	$49.84	6
New Mexico	164	$39.26	$29.67	4
Utah	143	$75.43	$60.28	3
West Virginia	132	$64.37	$53.74	4
Alaska	124	$88.53	$57.39	4
Guam	67	$92.28	$66.06	1
North Dakota	59	$40.06	$29.96	1
Wyoming	48	$71.90	$56.36	1
Maine	20	$34.07	$27.25	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
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
51703Complicated insertion of bladder tube$133.52
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.