How much does Medicare pay for CPT 52214?

Medicare allowed an average of $622.35 per service and paid $491.45 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2494.76, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 52214?

Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope. It was billed 3,637 times to 3,171 Medicare beneficiaries by 119 providers in 2024.

Does 52214 pay differently in an office than a hospital?

Yes. The allowed amount averaged $761.62 in an office setting and $402.14 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 52214 most?

Urology, with 3,330 services from 101 clinicians. Next are Ambulatory Surgical Center.

CPT 52214

Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope

$622.35Medicare-allowed amount per service, averaged across 3,637 services

Providers submitted

$2494.76

Asking price, not received

Medicare allowed

$622.35

The fee schedule figure

Medicare paid

$491.45

Balance is patient coinsurance

Providers submitted an average of $2494.76 for this code and Medicare allowed $622.35 — 4.0× 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 $491.45 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $761.62
Hospital / facility: $402.14

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. 2,228 services were billed in an office setting and 1,409 in a facility.

Services: 3,637
Beneficiaries: 3,171
Providers billing it: 119
Total allowed: $2,263,487

What Medicare pays for CPT 52214

Across 3,637 services billed by 119 providers to 3,171 beneficiaries, Medicare allowed an average of $622.35 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 52214

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	3,330	2,869	$554.25	101
Ambulatory Surgical Center	307	302	$1361.05	18

52214 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	1,031	$726.13	$497.56	10
Florida	605	$547.15	$407.36	24
New York	431	$793.66	$548.96	15
South Carolina	282	$302.84	$209.72	9
Texas	204	$684.12	$532.89	6
New Jersey	152	$684.69	$493.00	8
Mississippi	143	$551.07	$506.86	5
Massachusetts	106	$764.23	$565.15	1
Michigan	79	$410.56	$312.20	4
Arizona	73	$338.33	$267.92	4
Georgia	71	$755.53	$614.38	5
Tennessee	57	$1136.03	$973.94	4
Alabama	54	$374.43	$359.27	3
Virginia	48	$555.39	$449.06	3
Illinois	46	$117.50	$71.93	3
Utah	39	$518.81	$429.79	2
Arkansas	33	$609.02	$551.17	2
Ohio	32	$854.64	$700.98	2
Oregon	31	$714.64	$567.64	1
Kansas	27	$139.53	$103.63	2
Nebraska	25	$913.24	$739.65	2
Nevada	19	$107.94	$66.36	1
Louisiana	19	$117.02	$63.82	1
Pennsylvania	18	$143.45	$88.36	1
Oklahoma	12	$151.33	$118.03	1

Related codes

52287Exam with injections of chemical for destruction of bladder using an e$382.62
52281Dilation of urethra$396.69
52224Destruction of growth of bladder and urethra$754.81
52235Destruction and/or removal of growth of bladder and urethra$613.17
52204Biopsy of bladder$415.75
52234Destruction and/or removal of growth of bladder and urethra$719.29
52240Destruction and/or removal of large growth of bladder$789.42
52260Dilation of bladder$396.90

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.