52214

Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope

Medicare pricing data for 4,935 providers across 51 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $2,286 but Medicare allows only $375.53. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Prices vary significantly by location — from $106 in North Dakota to $591 in California. 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

Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope (HCPCS code 52214) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $375.53, but hospitals typically charge $2,286 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$75.11

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $375.53, your out-of-pocket cost would be approximately $75.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$375.53
Average Hospital Charge
$2,286
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,286.43
Medicare Allowed$375.53
Medicare Payment$296.26

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $296.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$591$2,3233831,854+57.5%
New York$580$3,2113121,022+54.5%
Nebraska$550$2,42640157+46.4%
Rhode Island$504$2,3232760+34.1%
Oregon$480$1,95852141+27.9%
Mississippi$459$2,15051329+22.3%
Massachusetts$449$2,279135444+19.7%
Wyoming$445$1,8701340+18.5%
New Jersey$428$3,923243890+13.9%
Maryland$411$2,42293229+9.4%
Florida$400$1,6964571,828+6.6%
Georgia$361$2,236150427-3.9%
Texas$350$2,235283753-6.7%
Kansas$338$2,06953196-9.9%
Utah$331$2,0073198-12.0%
Arizona$325$1,981108372-13.6%
Tennessee$312$1,505108299-16.9%
Indiana$306$2,526119271-18.4%
Idaho$304$9851830-19.1%
Alabama$289$1,42276202-23.1%
Delaware$287$1,6202886-23.7%
Virginia$281$1,935137358-25.0%
Pennsylvania$281$1,760248603-25.1%
Michigan$274$1,729136340-27.1%
Missouri$273$2,107108236-27.4%
South Carolina$262$2,741101556-30.2%
Ohio$258$1,726187385-31.4%
Colorado$255$2,07674161-32.1%
Wisconsin$239$4,79898167-36.3%
Illinois$238$2,704209491-36.7%
Alaska$230$7,7161149-38.8%
North Carolina$220$2,519143312-41.4%
Connecticut$215$2,71462155-42.8%
Washington$208$1,11199206-44.5%
New Hampshire$208$1,8732435-44.7%
Kentucky$185$1,29354112-50.9%
Minnesota$183$2,84064108-51.3%
Louisiana$160$1,43973201-57.3%
Iowa$160$2,35841102-57.4%
Oklahoma$156$1,16060159-58.6%
Arkansas$152$1,23041127-59.4%
Hawaii$151$1,578711-59.8%
Vermont$151$1,4181125-59.9%
Nevada$144$1,8252674-61.6%
West Virginia$140$1,2381637-62.7%
Montana$139$7291533-62.9%
District of Columbia$136$2,0201116-63.9%
Maine$133$9761223-64.5%
New Mexico$125$883726-66.7%
South Dakota$124$1,1871323-67.0%
North Dakota$106$3,391713-71.7%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber