How much does Medicare pay for CPT 52224?

Medicare allowed an average of $754.81 per service and paid $595.14 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2662.45, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 52224?

Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm. It was billed 11,662 times to 9,728 Medicare beneficiaries by 341 providers in 2024.

Does 52224 pay differently in an office than a hospital?

Yes. The allowed amount averaged $784.12 in an office setting and $693.48 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 52224 most?

Urology, with 9,994 services from 281 clinicians. Next are Ambulatory Surgical Center, Obstetrics & Gynecology.

CPT 52224

Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm

$754.81Medicare-allowed amount per service, averaged across 11,662 services

Providers submitted

$2662.45

Asking price, not received

Medicare allowed

$754.81

The fee schedule figure

Medicare paid

$595.14

Balance is patient coinsurance

Providers submitted an average of $2662.45 for this code and Medicare allowed $754.81 — 3.5× 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 $595.14 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $784.12
Hospital / facility: $693.48

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. 7,891 services were billed in an office setting and 3,771 in a facility.

Services: 11,662
Beneficiaries: 9,728
Providers billing it: 341
Total allowed: $8,802,594

What Medicare pays for CPT 52224

Across 11,662 services billed by 341 providers to 9,728 beneficiaries, Medicare allowed an average of $754.81 per service. That is 1.2 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 52224

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	9,994	8,211	$649.73	281
Ambulatory Surgical Center	1,511	1,367	$1466.09	56
Obstetrics & Gynecology	157	150	$598.57	4

52224 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	2,028	$778.78	$611.56	57
California	1,344	$747.85	$490.54	21
Texas	1,264	$703.42	$591.34	17
New York	1,245	$839.51	$580.24	34
Arizona	940	$754.19	$609.76	22
New Jersey	844	$889.23	$611.59	23
Illinois	493	$677.35	$513.66	20
Maryland	355	$1103.12	$875.20	13
Pennsylvania	318	$863.10	$683.65	15
Tennessee	295	$468.41	$404.63	5
Massachusetts	271	$445.87	$322.83	13
South Carolina	251	$643.81	$525.08	8
Virginia	231	$861.07	$730.59	8
Oklahoma	199	$623.57	$553.73	3
Michigan	152	$476.38	$361.79	8
Georgia	136	$789.64	$709.30	7
Ohio	112	$1192.91	$1015.36	5
Missouri	101	$561.15	$477.40	6
Kentucky	97	$915.25	$769.68	5
Alabama	97	$160.25	$127.40	4
Minnesota	89	$340.04	$267.85	4
North Carolina	84	$719.89	$600.90	4
Indiana	82	$283.54	$235.02	5
Oregon	81	$1234.35	$910.65	3
South Dakota	70	$631.99	$541.69	4
Mississippi	60	$955.63	$829.05	3
Arkansas	48	$571.45	$514.76	3
Colorado	45	$1542.79	$1278.83	2
Connecticut	39	$813.26	$579.17	1
Delaware	36	$189.77	$144.78	2
Nebraska	34	$1564.74	$1270.61	1
Kansas	33	$182.70	$114.45	2
Washington	30	$811.41	$581.78	2
Wisconsin	29	$179.28	$144.08	2
Louisiana	28	$692.18	$583.41	2
Rhode Island	20	$156.20	$144.92	1
Wyoming	15	$1561.68	$1274.75	1
North Dakota	14	$178.91	$143.10	1
Hawaii	13	$879.79	$604.43	1
Montana	13	$188.04	$138.21	1
Maine	13	$167.04	$132.82	1
West Virginia	13	$165.55	$122.69	1

Related codes

52287Exam with injections of chemical for destruction of bladder using an e$382.62
52281Dilation of urethra$396.69
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
52214Destruction of tissue of bladder$622.35
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.