How much does Medicare pay for CPT 51798?

Medicare allowed an average of $11.33 per service and paid $8.30 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $70.83, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 51798?

Ultrasound measurement of bladder capacity after voiding. It was billed 1,904,122 times to 1,426,513 Medicare beneficiaries by 9,700 providers in 2024.

Does 51798 pay differently in an office than a hospital?

Yes. The allowed amount averaged $11.33 in an office setting and $12.14 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 51798 most?

Urology, with 1,395,982 services from 6,046 clinicians. Next are Nurse Practitioner, Physician Assistant, Obstetrics & Gynecology.

CPT 51798

Ultrasound measurement of bladder capacity after voiding

$11.33Medicare-allowed amount per service, averaged across 1,904,122 services

Providers submitted

$70.83

Asking price, not received

Medicare allowed

$11.33

The fee schedule figure

Medicare paid

$8.30

Balance is patient coinsurance

Providers submitted an average of $70.83 for this code and Medicare allowed $11.33 — 6.3× 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 $8.30 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $11.33
Hospital / facility: $12.14

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,903,277 services were billed in an office setting and 845 in a facility.

Services: 1,904,122
Beneficiaries: 1,426,513
Providers billing it: 9,700
Total allowed: $21,573,702

What Medicare pays for CPT 51798

Across 1,904,122 services billed by 9,700 providers to 1,426,513 beneficiaries, Medicare allowed an average of $11.33 per service. That is 1.3 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 51798

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	1,395,982	1,022,425	$11.48	6,046
Nurse Practitioner	258,658	203,433	$10.70	1,634
Physician Assistant	185,303	149,126	$10.95	1,389
Obstetrics & Gynecology	48,276	38,562	$11.44	442
Internal Medicine	4,480	4,038	$11.97	68
Family Practice	2,482	1,557	$11.99	23
General Surgery	2,405	1,674	$12.23	8
Nephrology	2,006	1,935	$11.48	24
Certified Clinical Nurse Specialist	1,100	904	$10.28	6
Undefined Physician type	509	479	$14.00	6
Diagnostic Radiology	487	485	$10.79	17
Certified Nurse Midwife	412	261	$10.60	4
Hematology-Oncology	326	272	$12.22	2
Pediatric Medicine	276	205	$13.06	1
Medical Oncology	253	195	$12.56	1

51798 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	187,624	$11.17	$8.02	758
California	168,954	$13.19	$8.10	689
New York	154,080	$13.08	$8.08	673
Texas	144,479	$10.86	$7.92	694
Illinois	92,121	$11.32	$7.82	378
Pennsylvania	91,128	$11.29	$7.79	510
New Jersey	73,819	$12.57	$8.12	309
Massachusetts	62,254	$12.34	$7.94	265
Arizona	58,521	$10.75	$7.83	258
North Carolina	57,277	$10.37	$7.74	367
Tennessee	56,832	$9.95	$7.80	239
Virginia	55,589	$11.16	$7.70	278
Maryland	50,588	$12.11	$7.94	203
Georgia	48,908	$10.46	$7.76	357
Michigan	42,749	$10.88	$8.02	242
South Carolina	39,377	$10.36	$7.77	192
Indiana	38,354	$10.09	$7.56	273
Missouri	38,200	$10.26	$7.75	213
Oklahoma	37,904	$9.83	$7.81	126
Ohio	37,807	$10.28	$7.63	315
Colorado	28,506	$11.61	$7.75	190
Washington	24,053	$12.00	$7.71	182
Arkansas	22,889	$9.45	$7.54	86
Louisiana	21,246	$9.95	$7.84	124
Connecticut	20,976	$12.37	$7.79	130
Alabama	20,748	$9.56	$7.97	149
Mississippi	19,809	$9.49	$7.43	82
Minnesota	19,160	$11.44	$7.88	175
Oregon	17,626	$11.23	$7.59	123
Kentucky	17,507	$9.93	$7.31	123
Nevada	17,296	$11.10	$7.47	92
Kansas	16,281	$10.08	$7.71	90
Iowa	16,093	$10.06	$7.51	93
Nebraska	15,689	$9.92	$7.56	76
Wisconsin	14,808	$10.42	$7.56	175
Delaware	12,553	$11.27	$7.63	35
Utah	10,106	$10.36	$7.40	83
New Hampshire	7,244	$11.61	$7.67	39
Idaho	6,595	$10.20	$7.49	43
South Dakota	6,103	$10.79	$7.41	33
Rhode Island	5,145	$11.41	$7.73	43
District of Columbia	4,425	$13.22	$7.92	27
Wyoming	4,385	$10.89	$7.64	15
New Mexico	4,325	$10.41	$7.56	30
Maine	2,703	$10.89	$7.47	21
Montana	2,665	$11.22	$7.76	25
Alaska	2,615	$11.85	$7.37	26
West Virginia	2,012	$9.78	$7.89	17
Hawaii	1,917	$12.47	$7.92	17
Puerto Rico	866	$10.65	$8.17	6
Vermont	408	$10.95	$7.84	3
U.S. Virgin Islands	345	$11.03	$7.25	1
North Dakota	285	$10.98	$7.20	5
Guam	173	$12.80	$7.58	2

Related codes

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
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.