How much does Medicare pay for CPT 52234?

Medicare allowed an average of $719.29 per service and paid $568.36 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3014.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 52234?

Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm. It was billed 6,379 times to 5,793 Medicare beneficiaries by 314 providers in 2024.

Does 52234 pay differently in an office than a hospital?

Yes. The allowed amount averaged $253.91 in an office setting and $747.38 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 52234 most?

Urology, with 3,859 services from 212 clinicians. Next are Ambulatory Surgical Center, General Surgery.

CPT 52234

Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm

$719.29Medicare-allowed amount per service, averaged across 6,379 services

Providers submitted

$3014.22

Asking price, not received

Medicare allowed

$719.29

The fee schedule figure

Medicare paid

$568.36

Balance is patient coinsurance

Providers submitted an average of $3014.22 for this code and Medicare allowed $719.29 — 4.2× 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 $568.36 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $253.91
Hospital / facility: $747.38

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 363 services were billed in an office setting and 6,016 in a facility.

Services: 6,379
Beneficiaries: 5,793
Providers billing it: 314
Total allowed: $4,588,351

What Medicare pays for CPT 52234

Across 6,379 services billed by 314 providers to 5,793 beneficiaries, Medicare allowed an average of $719.29 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 52234

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	3,859	3,481	$230.80	212
Ambulatory Surgical Center	2,471	2,268	$1491.52	101
General Surgery	49	44	$248.18	1

52234 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	696	$882.18	$741.26	32
Maryland	565	$1021.12	$830.88	22
New York	488	$603.89	$426.81	21
Virginia	414	$819.21	$694.60	13
California	408	$541.79	$342.70	26
New Jersey	403	$834.08	$610.85	20
Illinois	299	$580.76	$446.06	16
Pennsylvania	284	$397.69	$302.72	13
South Carolina	277	$542.38	$448.28	8
Texas	216	$820.31	$683.52	13
Arizona	188	$539.42	$430.57	8
Ohio	187	$1194.93	$1019.13	5
Tennessee	177	$1046.24	$914.31	8
Massachusetts	169	$356.75	$267.98	11
Indiana	148	$680.55	$549.47	9
Minnesota	133	$221.77	$173.54	6
Washington	104	$722.39	$541.26	7
Missouri	103	$775.06	$637.21	6
Georgia	96	$748.44	$645.73	6
Michigan	85	$229.11	$177.35	6
Arkansas	77	$494.53	$417.78	4
Mississippi	77	$1322.11	$1216.33	4
Nevada	70	$741.47	$594.94	3
Oregon	70	$780.64	$569.82	4
Colorado	60	$1164.35	$952.71	4
Iowa	57	$686.35	$596.29	4
Kentucky	52	$693.68	$576.54	3
Kansas	46	$1042.76	$880.88	3
Delaware	44	$1112.45	$852.98	3
Oklahoma	43	$683.81	$600.92	3
West Virginia	39	$231.06	$180.56	2
Wisconsin	37	$208.22	$166.84	3
North Carolina	35	$231.77	$175.29	2
North Dakota	32	$208.28	$170.02	2
Nebraska	27	$903.59	$735.54	2
Idaho	27	$1498.45	$1244.17	1
Rhode Island	26	$231.93	$176.73	2
South Dakota	25	$207.34	$160.33	2
New Hampshire	23	$196.46	$155.76	2
District of Columbia	19	$227.14	$163.90	1
Maine	17	$211.27	$177.54	1
Utah	13	$204.32	$145.73	1
Connecticut	12	$233.30	$172.05	1
Alabama	11	$210.09	$140.01	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
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.