How much does Medicare pay for CPT 57150?

Medicare allowed an average of $52.11 per service and paid $38.20 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $148.45, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 57150?

Irrigation of vagina and/or application of drug to treat infection. It was billed 11,103 times to 5,172 Medicare beneficiaries by 173 providers in 2024.

Does 57150 pay differently in an office than a hospital?

Yes. The allowed amount averaged $52.63 in an office setting and $23.05 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 57150 most?

Obstetrics & Gynecology, with 6,906 services from 105 clinicians. Next are Nurse Practitioner, Urology, Physician Assistant.

CPT 57150

Irrigation of vagina and/or application of drug to treat infection

$52.11Medicare-allowed amount per service, averaged across 11,103 services

Providers submitted

$148.45

Asking price, not received

Medicare allowed

$52.11

The fee schedule figure

Medicare paid

$38.20

Balance is patient coinsurance

Providers submitted an average of $148.45 for this code and Medicare allowed $52.11 — 2.8× 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 $38.20 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $52.63
Hospital / facility: $23.05

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. 10,910 services were billed in an office setting and 193 in a facility.

Services: 11,103
Beneficiaries: 5,172
Providers billing it: 173
Total allowed: $578,577

What Medicare pays for CPT 57150

Across 11,103 services billed by 173 providers to 5,172 beneficiaries, Medicare allowed an average of $52.11 per service. That is 2.1 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 57150

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	6,906	2,977	$51.88	105
Nurse Practitioner	1,540	848	$45.36	34
Urology	1,106	614	$60.14	14
Physician Assistant	1,085	542	$50.40	16
Undefined Physician type	393	168	$64.10	2
Gynecological Oncology	41	12	$55.85	1
Certified Nurse Midwife	32	11	$55.55	1

57150 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	1,955	$52.00	$36.86	28
New York	1,753	$56.43	$35.32	26
California	1,219	$56.82	$37.84	18
New Jersey	1,056	$59.02	$37.62	16
Massachusetts	739	$45.94	$29.49	11
Pennsylvania	717	$32.09	$25.77	6
Ohio	695	$45.03	$33.25	14
Illinois	694	$57.38	$38.84	7
Maryland	297	$64.36	$40.92	2
Virginia	220	$54.82	$41.67	2
Texas	204	$51.58	$38.65	7
Michigan	192	$52.57	$36.64	4
Arizona	179	$50.33	$37.93	4
Alabama	166	$40.29	$30.49	3
Tennessee	151	$47.47	$36.26	5
Georgia	147	$53.07	$40.20	2
Louisiana	134	$49.92	$37.29	2
New Mexico	131	$47.37	$33.02	4
Washington	63	$53.10	$33.34	1
Connecticut	58	$55.85	$34.46	2
Arkansas	58	$42.40	$30.23	1
District of Columbia	51	$62.20	$40.81	1
Oklahoma	51	$40.97	$33.10	1
Colorado	44	$58.54	$40.83	1
West Virginia	35	$52.64	$39.51	1
Hawaii	31	$53.51	$39.86	1
South Carolina	27	$49.17	$45.38	1
Indiana	21	$25.45	$21.94	1
Minnesota	15	$50.31	$34.78	1

Related codes

57160Fitting and insertion of vaginal support device$65.75
57156Insertion of device into vagina for radiation therapy$164.67
57120Suture closure of vagina and vaginal opening$299.77

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.