How much does Medicare pay for CPT 51728?

Medicare allowed an average of $308.93 per service and paid $239.98 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $932.70, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 51728?

Complex measurement of pressure of urine flow in bladder with voiding pressure studies. It was billed 65,294 times to 62,034 Medicare beneficiaries by 1,787 providers in 2024.

Does 51728 pay differently in an office than a hospital?

Yes. The allowed amount averaged $330.17 in an office setting and $100.76 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 51728 most?

Urology, with 55,122 services from 1,450 clinicians. Next are Obstetrics & Gynecology, Nurse Practitioner, Physician Assistant.

CPT 51728

Complex measurement of pressure of urine flow in bladder with voiding pressure studies

$308.93Medicare-allowed amount per service, averaged across 65,294 services

Providers submitted

$932.70

Asking price, not received

Medicare allowed

$308.93

The fee schedule figure

Medicare paid

$239.98

Balance is patient coinsurance

Providers submitted an average of $932.70 for this code and Medicare allowed $308.93 — 3.0× 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 $239.98 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $330.17
Hospital / facility: $100.76

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. 59,249 services were billed in an office setting and 6,045 in a facility.

Services: 65,294
Beneficiaries: 62,034
Providers billing it: 1,787
Total allowed: $20,171,275

What Medicare pays for CPT 51728

Across 65,294 services billed by 1,787 providers to 62,034 beneficiaries, Medicare allowed an average of $308.93 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 51728

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	55,122	51,978	$316.87	1,450
Obstetrics & Gynecology	4,102	4,038	$281.08	142
Nurse Practitioner	2,975	2,949	$221.66	103
Physician Assistant	2,306	2,287	$287.08	77
Undefined Physician type	352	350	$399.28	4
Ambulatory Surgical Center	185	184	$136.68	2
General Surgery	40	40	$373.06	1
Physical Medicine and Rehabilitation	37	34	$109.06	1
Pediatric Medicine	33	33	$422.66	1
Osteopathic Manipulative Medicine	29	29	$94.31	1
Internal Medicine	27	27	$227.27	1
Surgical Oncology	25	25	$109.52	1
Certified Nurse Midwife	24	24	$336.97	1
Radiation Oncology	23	23	$255.29	1
Gynecological Oncology	14	13	$426.54	1

51728 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	10,330	$385.19	$264.09	176
New York	5,706	$378.12	$256.94	157
Texas	4,736	$293.78	$233.90	123
Arizona	3,589	$327.51	$257.10	72
Florida	3,543	$321.98	$255.81	105
Georgia	3,517	$260.02	$206.38	94
Michigan	3,340	$346.93	$262.07	69
New Jersey	2,403	$371.45	$259.73	84
Ohio	2,237	$172.42	$192.02	83
Missouri	1,974	$211.87	$170.71	45
Tennessee	1,912	$246.25	$242.93	50
Massachusetts	1,835	$297.23	$206.01	49
Pennsylvania	1,711	$270.04	$207.32	58
Virginia	1,267	$263.17	$216.17	46
North Carolina	1,236	$234.80	$228.83	40
Washington	1,143	$301.36	$219.70	29
Illinois	1,092	$323.14	$249.84	45
Maryland	1,086	$273.37	$204.83	30
Indiana	1,077	$280.88	$250.24	41
Colorado	877	$356.26	$268.12	36
South Carolina	870	$244.54	$232.77	24
Nevada	808	$348.17	$273.21	19
Nebraska	743	$307.54	$265.22	16
Oregon	672	$257.22	$193.71	25
Kansas	647	$264.84	$223.42	27
Wisconsin	613	$142.60	$112.89	19
Iowa	602	$240.12	$204.13	28
Alabama	568	$195.68	$168.59	21
Minnesota	536	$326.68	$252.47	19
Connecticut	506	$355.69	$251.75	20
Oklahoma	433	$319.05	$277.45	9
Idaho	428	$300.20	$247.41	16
District of Columbia	391	$360.25	$237.48	9
Delaware	359	$209.78	$159.30	9
Utah	305	$293.84	$228.54	13
Alaska	286	$379.24	$260.62	6
Arkansas	275	$297.35	$265.10	9
Louisiana	271	$199.56	$168.24	10
Kentucky	215	$195.15	$226.54	9
New Hampshire	191	$233.18	$177.10	7
Montana	179	$218.32	$162.22	7
Mississippi	130	$178.10	$149.68	5
New Mexico	123	$119.44	$91.16	5
Vermont	108	$96.63	$69.30	3
Rhode Island	95	$206.04	$156.74	6
Wyoming	84	$305.73	$248.28	2
West Virginia	54	$147.29	$140.14	3
North Dakota	49	$92.51	$75.86	3
Hawaii	47	$101.25	$74.50	1
Maine	42	$233.40	$173.89	2
Puerto Rico	42	$347.05	$284.17	2
South Dakota	11	$352.06	$283.88	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
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.