How much does Medicare pay for CPT 57288?

Medicare allowed an average of $577.84 per service and paid $458.53 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3087.66, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 57288?

Creation of sling around urethra in female to control leakage. It was billed 14,616 times to 14,576 Medicare beneficiaries by 644 providers in 2024.

Does 57288 pay differently in an office than a hospital?

Yes. The allowed amount averaged $546.06 in an office setting and $578.14 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 57288 most?

Obstetrics & Gynecology, with 9,377 services from 396 clinicians. Next are Urology, Physician Assistant, Ambulatory Surgical Center.

CPT 57288

Creation of sling around urethra in female to control leakage

$577.84Medicare-allowed amount per service, averaged across 14,616 services

Providers submitted

$3087.66

Asking price, not received

Medicare allowed

$577.84

The fee schedule figure

Medicare paid

$458.53

Balance is patient coinsurance

Providers submitted an average of $3087.66 for this code and Medicare allowed $577.84 — 5.3× 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 $458.53 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $546.06
Hospital / facility: $578.14

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 135 services were billed in an office setting and 14,481 in a facility.

Services: 14,616
Beneficiaries: 14,576
Providers billing it: 644
Total allowed: $8,445,709

What Medicare pays for CPT 57288

Across 14,616 services billed by 644 providers to 14,576 beneficiaries, Medicare allowed an average of $577.84 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 57288

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	9,377	9,352	$503.99	396
Urology	2,283	2,278	$531.88	118
Physician Assistant	1,198	1,194	$63.45	56
Ambulatory Surgical Center	880	876	$2495.39	45
Nurse Practitioner	478	476	$65.42	19
Undefined Physician type	334	334	$492.09	7
Gynecological Oncology	66	66	$574.75	3

57288 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	1,549	$602.19	$487.14	63
California	1,450	$698.72	$480.15	57
Texas	1,386	$511.21	$405.23	59
Illinois	862	$703.71	$541.67	37
Pennsylvania	601	$543.45	$426.68	25
Arizona	577	$552.79	$447.41	25
New York	568	$616.18	$426.59	24
New Jersey	499	$666.21	$487.81	22
Ohio	427	$519.72	$426.33	20
Massachusetts	412	$536.51	$407.08	19
Virginia	409	$491.51	$391.12	16
Tennessee	404	$824.57	$723.13	20
Georgia	394	$512.88	$410.90	16
South Carolina	372	$645.07	$535.58	14
Maryland	372	$636.07	$486.43	17
Indiana	365	$514.82	$433.65	11
North Carolina	301	$417.85	$343.34	16
Nebraska	298	$696.73	$591.10	9
Michigan	277	$633.15	$498.60	15
Missouri	251	$697.85	$594.25	12
Oregon	239	$335.95	$264.95	10
Alabama	238	$450.91	$391.79	14
Colorado	192	$369.75	$287.94	12
Oklahoma	184	$497.93	$419.78	9
Kansas	182	$468.59	$385.44	8
Connecticut	150	$579.70	$429.34	7
Nevada	145	$315.20	$254.02	6
Iowa	137	$769.39	$679.63	6
Washington	136	$502.04	$389.61	7
Wisconsin	130	$420.01	$361.67	8
Kentucky	113	$438.26	$361.04	6
South Dakota	106	$421.43	$336.19	5
Arkansas	103	$738.33	$641.94	6
Delaware	93	$480.08	$376.61	3
Louisiana	89	$390.38	$309.04	5
Minnesota	88	$361.45	$299.76	5
Utah	85	$336.96	$272.37	4
District of Columbia	77	$566.54	$394.11	4
New Hampshire	70	$504.60	$388.40	4
Montana	68	$158.59	$117.90	4
Idaho	48	$360.39	$296.40	3
West Virginia	39	$587.74	$434.59	2
Mississippi	34	$501.93	$420.21	2
Hawaii	28	$423.58	$354.91	2
New Mexico	26	$514.97	$403.60	2
North Dakota	16	$439.61	$364.79	1
Rhode Island	14	$585.22	$459.04	1
Alaska	12	$2921.66	$2156.39	1

Related codes

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
57240Repair of bladder hernia into vaginal wall$442.59

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.