How much does Medicare pay for CPT 57240?

Medicare allowed an average of $442.59 per service and paid $351.29 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2583.86, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 57240?

Repair of bladder hernia into vaginal wall. It was billed 1,472 times to 1,461 Medicare beneficiaries by 92 providers in 2024.

Which specialty bills 57240 most?

Obstetrics & Gynecology, with 817 services from 50 clinicians. Next are Urology, Ambulatory Surgical Center, Physician Assistant.

CPT 57240

Repair of bladder hernia into vaginal wall

$442.59Medicare-allowed amount per service, averaged across 1,472 services

Providers submitted

$2583.86

Asking price, not received

Medicare allowed

$442.59

The fee schedule figure

Medicare paid

$351.29

Balance is patient coinsurance

Providers submitted an average of $2583.86 for this code and Medicare allowed $442.59 — 5.8× 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 $351.29 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,472
Beneficiaries: 1,461
Providers billing it: 92
Total allowed: $651,492

What Medicare pays for CPT 57240

Across 1,472 services billed by 92 providers to 1,461 beneficiaries, Medicare allowed an average of $442.59 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 57240

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	817	813	$352.43	50
Urology	346	343	$345.20	23
Ambulatory Surgical Center	175	172	$1304.05	10
Physician Assistant	79	78	$45.44	5
Nurse Practitioner	22	22	$42.29	2
Gynecological Oncology	20	20	$298.16	1
Undefined Physician type	13	13	$416.86	1

57240 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	150	$558.82	$383.09	9
Tennessee	141	$521.20	$455.91	7
Texas	119	$715.75	$579.91	8
Illinois	110	$577.97	$460.95	6
Florida	102	$420.96	$340.49	6
Virginia	91	$322.81	$253.54	5
New Jersey	73	$380.22	$286.42	4
South Carolina	71	$280.99	$230.38	5
Ohio	55	$325.92	$267.52	4
Oklahoma	53	$504.40	$413.55	3
New York	53	$655.68	$448.07	3
Delaware	49	$213.98	$165.87	2
Arizona	47	$358.94	$312.29	3
Maryland	47	$499.84	$418.28	3
Oregon	41	$159.45	$126.44	3
Pennsylvania	31	$355.37	$289.81	2
Georgia	25	$298.81	$253.13	2
Massachusetts	25	$286.56	$205.07	2
Missouri	24	$358.95	$301.58	2
Michigan	23	$388.61	$292.15	2
Kentucky	22	$173.54	$136.99	2
Nevada	20	$298.16	$253.41	1
Wisconsin	18	$280.35	$240.87	1
South Dakota	13	$416.86	$350.58	1
Nebraska	13	$443.99	$388.65	1
Connecticut	12	$321.97	$241.21	1
Louisiana	11	$305.49	$227.59	1
North Carolina	11	$285.38	$240.81	1
Alabama	11	$240.26	$211.84	1
Vermont	11	$579.93	$483.06	1

Related codes

57288Creation of sling around urethra in female to control leakage$577.84
57250Repair of herniated rectum into vaginal wall$337.21
57260Plastic repair of vagina and tissue separating vagina$551.79
57282Repair of pelvic ligaments through vagina$657.07
57265Repair of bulging of rectum and bladder into vaginal wall$629.86
57283Repair of prolapsing vaginal vault through vagina$345.40
57267Insertion of artificial material for pelvic floor defect$225.45

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.