How much does Medicare pay for CPT 51797?

Medicare allowed an average of $155.21 per service and paid $123.49 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $515.72, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 51797?

Insertion of device into abdomen with pressure and urine flow rate study. It was billed 80,675 times to 78,879 Medicare beneficiaries by 2,324 providers in 2024.

Does 51797 pay differently in an office than a hospital?

Yes. The allowed amount averaged $169.56 in an office setting and $42.27 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 51797 most?

Urology, with 48,082 services from 1,419 clinicians. Next are Obstetrics & Gynecology, Nurse Practitioner, Physician Assistant.

CPT 51797

Insertion of device into abdomen with pressure and urine flow rate study

$155.21Medicare-allowed amount per service, averaged across 80,675 services

Providers submitted

$515.72

Asking price, not received

Medicare allowed

$155.21

The fee schedule figure

Medicare paid

$123.49

Balance is patient coinsurance

Providers submitted an average of $515.72 for this code and Medicare allowed $155.21 — 3.3× 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 $123.49 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $169.56
Hospital / facility: $42.27

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. 71,579 services were billed in an office setting and 9,096 in a facility.

Services: 80,675
Beneficiaries: 78,879
Providers billing it: 2,324
Total allowed: $12,521,567

What Medicare pays for CPT 51797

Across 80,675 services billed by 2,324 providers to 78,879 beneficiaries, Medicare allowed an average of $155.21 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 51797

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	48,082	46,856	$157.63	1,419
Obstetrics & Gynecology	22,970	22,529	$157.94	587
Nurse Practitioner	5,105	5,079	$117.64	184
Physician Assistant	3,323	3,306	$146.67	113
Undefined Physician type	590	585	$207.87	7
Internal Medicine	235	159	$197.33	3
Certified Nurse Midwife	103	103	$179.10	2
Gynecological Oncology	81	79	$183.97	2
General Surgery	52	52	$166.29	2
Physical Medicine and Rehabilitation	37	34	$41.83	1
Pediatric Medicine	32	32	$220.29	1
Surgical Oncology	25	25	$42.14	1
Radiation Oncology	23	23	$143.30	1
Certified Clinical Nurse Specialist	17	17	$145.28	1

51797 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	8,769	$168.41	$135.93	208
California	7,331	$184.02	$128.39	173
Texas	6,821	$157.96	$128.21	173
New York	6,270	$189.55	$129.31	192
New Jersey	3,834	$194.50	$137.25	119
Georgia	3,472	$128.52	$110.92	109
Arizona	3,139	$165.40	$135.45	80
Pennsylvania	2,899	$145.04	$112.68	85
Massachusetts	2,623	$165.42	$115.78	65
Ohio	2,385	$105.56	$88.52	86
Illinois	2,241	$147.67	$117.01	80
North Carolina	2,215	$137.73	$116.71	72
Virginia	2,016	$142.16	$110.88	59
Maryland	2,009	$176.13	$130.55	50
Tennessee	2,002	$148.93	$128.92	53
Missouri	1,815	$104.08	$87.35	38
South Carolina	1,659	$156.16	$132.90	32
Michigan	1,424	$140.36	$113.72	61
Colorado	1,413	$165.10	$126.70	50
Indiana	1,232	$147.83	$126.92	45
Oklahoma	1,135	$164.04	$146.48	19
Mississippi	1,096	$119.11	$105.52	22
Oregon	1,074	$119.18	$90.47	37
Washington	1,061	$139.99	$104.03	33
Wisconsin	963	$74.07	$60.50	34
Alabama	948	$122.70	$108.55	34
Kansas	850	$144.70	$123.42	33
Connecticut	819	$174.35	$126.15	25
Nebraska	770	$161.40	$135.94	16
Iowa	712	$113.44	$97.49	28
Minnesota	684	$166.88	$129.88	27
Nevada	604	$175.58	$146.90	17
Kentucky	486	$144.41	$127.87	20
Delaware	441	$80.38	$63.07	11
Louisiana	433	$118.43	$103.94	20
Arkansas	421	$154.04	$142.14	14
District of Columbia	360	$179.57	$120.85	9
Utah	251	$124.13	$103.26	13
Idaho	239	$107.18	$87.84	11
Rhode Island	198	$63.88	$49.06	12
New Hampshire	194	$140.24	$105.85	6
South Dakota	184	$36.37	$28.86	3
New Mexico	176	$59.11	$46.92	7
Montana	171	$60.61	$46.49	6
West Virginia	164	$82.81	$70.94	10
Hawaii	123	$128.85	$99.53	3
Maine	122	$104.26	$86.94	6
North Dakota	110	$75.31	$62.14	6
Vermont	93	$36.93	$29.99	3
Puerto Rico	91	$183.15	$147.55	5
Wyoming	84	$150.45	$125.76	2
Alaska	49	$187.07	$130.26	2

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
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
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.