How much does Medicare pay for CPT 52310?

Medicare allowed an average of $344.09 per service and paid $270.69 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1341.14, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 52310?

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope. It was billed 59,967 times to 57,791 Medicare beneficiaries by 2,540 providers in 2024.

Does 52310 pay differently in an office than a hospital?

Yes. The allowed amount averaged $302.04 in an office setting and $402.76 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 52310 most?

Urology, with 46,953 services from 2,232 clinicians. Next are Ambulatory Surgical Center, Physician Assistant, Nurse Practitioner.

CPT 52310

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope

$344.09Medicare-allowed amount per service, averaged across 59,967 services

Providers submitted

$1341.14

Asking price, not received

Medicare allowed

$344.09

The fee schedule figure

Medicare paid

$270.69

Balance is patient coinsurance

Providers submitted an average of $1341.14 for this code and Medicare allowed $344.09 — 3.9× 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 $270.69 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $302.04
Hospital / facility: $402.76

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 34,934 services were billed in an office setting and 25,033 in a facility.

Services: 59,967
Beneficiaries: 57,791
Providers billing it: 2,540
Total allowed: $20,634,045

What Medicare pays for CPT 52310

Across 59,967 services billed by 2,540 providers to 57,791 beneficiaries, Medicare allowed an average of $344.09 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 52310

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	46,953	45,218	$256.06	2,232
Ambulatory Surgical Center	8,876	8,507	$875.30	127
Physician Assistant	1,786	1,748	$216.18	84
Nurse Practitioner	1,528	1,502	$197.80	70
General Surgery	697	691	$185.34	22
Internal Medicine	42	40	$317.21	1
Undefined Physician type	39	39	$124.28	1
Family Practice	16	16	$136.09	1
Osteopathic Manipulative Medicine	15	15	$136.06	1
Neurology	15	15	$139.66	1

52310 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	5,119	$362.00	$292.84	205
Pennsylvania	3,987	$380.72	$304.77	155
Maryland	3,357	$536.01	$427.40	98
California	3,314	$315.57	$221.00	159
New York	3,143	$364.21	$259.91	137
Illinois	2,621	$281.02	$215.88	124
Ohio	2,592	$325.20	$266.60	103
Georgia	2,193	$443.39	$359.42	82
Texas	2,095	$297.68	$239.04	104
Arizona	1,775	$345.21	$280.23	69
Massachusetts	1,605	$326.45	$242.36	68
New Jersey	1,580	$417.81	$302.97	74
Missouri	1,527	$275.72	$228.75	68
Tennessee	1,462	$328.12	$285.20	57
Washington	1,332	$305.73	$226.64	61
Indiana	1,330	$226.42	$188.83	61
North Carolina	1,320	$274.26	$226.03	76
South Carolina	1,310	$295.91	$247.91	54
Nebraska	1,290	$412.55	$338.32	38
Michigan	1,219	$256.72	$204.68	59
Virginia	1,172	$303.81	$234.56	57
Colorado	1,141	$496.19	$391.88	42
Mississippi	1,107	$397.02	$362.78	32
Kentucky	986	$446.14	$376.68	29
Oregon	972	$418.50	$317.77	39
Kansas	909	$360.07	$309.69	33
Wisconsin	903	$227.89	$188.03	44
Minnesota	859	$276.53	$217.76	52
South Dakota	773	$412.24	$360.31	19
Oklahoma	626	$276.64	$237.12	31
Louisiana	615	$250.43	$210.38	31
Iowa	600	$227.58	$192.29	29
New Hampshire	577	$234.33	$178.55	28
Utah	571	$258.99	$214.70	26
Arkansas	472	$277.07	$244.13	22
Connecticut	446	$293.72	$213.32	26
Nevada	432	$384.14	$310.86	19
Idaho	403	$259.12	$217.64	18
North Dakota	298	$141.21	$112.73	10
Alabama	279	$251.41	$211.35	16
Maine	274	$194.32	$151.57	15
Montana	242	$170.85	$133.42	12
District of Columbia	230	$327.54	$231.38	8
Vermont	197	$140.67	$110.47	12
West Virginia	185	$185.00	$144.65	10
Delaware	139	$304.80	$229.33	8
New Mexico	110	$247.31	$206.44	5
Rhode Island	75	$288.68	$222.77	5
Alaska	68	$311.32	$216.68	4
Hawaii	64	$671.55	$503.73	3
Wyoming	60	$316.76	$245.99	2
ZZ	11	$143.06	$116.74	1

Related codes

52332Insertion of stent in ureter$224.05
52356Crushing of stone of ureter$687.05
52352Removal or manipulation of stone in ureter or kidney$408.05
52351Diagnostic exam of bladder$704.52
52353Crushing of stone of ureter$739.44
52317Crushing, fragmenting, and removal of bladder stones, less than 2.5 cm$838.39
52315Complicated removal of foreign body$464.15

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.