51715

Injection of implant material beneath lining of bladder and/or urethra using an endoscope

Medicare pricing data for 3,034 providers across 47 states

🤖AI Overview

Prices vary significantly by location — from $157 in Hawaii to $1,012 in Maryland. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Injection of implant material beneath lining of bladder and/or urethra using an endoscope (HCPCS code 51715) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $577.86, but hospitals typically charge $2,203 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$115.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $577.86, your out-of-pocket cost would be approximately $115.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$577.86
Average Hospital Charge
$2,203
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,202.85
Medicare Allowed$577.86
Medicare Payment$455.97

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $455.97 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$1,012$2,57985841+75.1%
Oregon$894$2,81031192+54.6%
Mississippi$877$2,30234295+51.8%
Delaware$801$2,1211245+38.7%
Nebraska$790$2,05124211+36.7%
Kansas$734$2,63331196+27.0%
Pennsylvania$705$1,788142872+22.0%
New Jersey$684$3,169111382+18.4%
Iowa$667$3,0632781+15.5%
Florida$622$2,5462701,749+7.7%
Missouri$620$2,22851322+7.4%
California$607$2,8472501,159+5.1%
Colorado$598$2,89051206+3.5%
Tennessee$593$1,71298580+2.7%
Alabama$581$1,71940154+0.5%
Indiana$559$3,64154232-3.3%
Texas$552$2,5642371,163-4.5%
Georgia$545$1,829117473-5.7%
Illinois$543$3,212101370-6.0%
Rhode Island$542$1,4721026-6.1%
South Carolina$535$2,20161326-7.4%
Michigan$532$1,683101413-8.0%
Minnesota$531$2,24945160-8.1%
Arizona$512$3,04079415-11.4%
Washington$512$1,89473337-11.5%
Idaho$489$1,24423155-15.4%
Virginia$487$1,57262216-15.7%
Utah$456$1,6262799-21.2%
Oklahoma$434$1,35651334-25.0%
New York$425$1,660126500-26.5%
Arkansas$385$1,13639175-33.3%
Connecticut$385$1,98535118-33.4%
Kentucky$385$1,5033192-33.5%
North Carolina$377$1,44391417-34.8%
Ohio$359$1,60394375-37.9%
Nevada$358$1,1631256-38.0%
South Dakota$342$9261586-40.8%
New Mexico$329$1,7861023-43.1%
Massachusetts$324$1,52675322-44.0%
Wisconsin$319$2,52745145-44.8%
Louisiana$301$1,17244175-47.9%
District of Columbia$281$9561575-51.3%
New Hampshire$241$1,3921182-58.2%
Montana$212$7501253-63.4%
Maine$187$7291334-67.6%
West Virginia$185$6041137-68.0%
Hawaii$157$810616-72.9%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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