52234

Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm

Medicare pricing data for 6,944 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $216 in South Dakota to $701 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

Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm (HCPCS code 52234) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $400.13, but hospitals typically charge $1,754 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$80.03

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $400.13, your out-of-pocket cost would be approximately $80.03. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$400.13
Average Hospital Charge
$1,754
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,754.09
Medicare Allowed$400.13
Medicare Payment$314.95

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $314.95 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$701$2,0101601,111+75.2%
Alaska$616$10,0611653+53.9%
Colorado$527$3,003110348+31.8%
Wyoming$525$2,7211261+31.2%
Florida$521$2,4895322,203+30.2%
Delaware$513$1,41920164+28.1%
Mississippi$499$1,61762252+24.7%
New Jersey$476$3,0182771,223+19.0%
Virginia$472$1,5891871,067+18.0%
Tennessee$463$1,545172800+15.8%
Oregon$461$1,63785346+15.2%
California$453$2,1005271,852+13.3%
Arizona$432$2,092142571+8.0%
Idaho$425$1,05534162+6.1%
Iowa$424$1,17858248+5.9%
Ohio$420$1,2972821,078+4.9%
Montana$417$1,09629122+4.3%
Nebraska$417$1,38847212+4.2%
Missouri$403$1,695137643+0.8%
Indiana$401$2,587176768+0.2%
Georgia$396$1,668213887-1.0%
Kansas$391$1,77671398-2.2%
Nevada$387$2,20135191-3.4%
Texas$379$1,8824451,442-5.2%
Alabama$365$1,23091282-8.7%
Illinois$345$1,7092671,082-13.8%
Pennsylvania$343$1,3373401,436-14.2%
Kentucky$340$1,23778326-15.1%
New York$337$1,4604581,839-15.8%
Puerto Rico$337$3911013-15.8%
South Carolina$336$1,415126726-16.0%
Utah$327$1,21645150-18.4%
Washington$320$880141549-19.9%
Connecticut$320$1,984107353-20.0%
Minnesota$304$1,784120413-24.1%
Wisconsin$301$2,651130473-24.7%
Massachusetts$299$1,343208836-25.3%
Arkansas$286$88748265-28.5%
Rhode Island$274$68924115-31.4%
North Carolina$274$1,242237701-31.6%
Oklahoma$269$94684325-32.7%
Michigan$264$851209703-34.1%
New Hampshire$260$1,65442145-35.0%
New Mexico$260$1,0642567-35.1%
Louisiana$257$1,07191278-35.7%
District of Columbia$245$9931875-38.8%
Hawaii$244$1,1171533-38.9%
Maine$231$72144141-42.4%
West Virginia$227$77638157-43.3%
North Dakota$227$7451055-43.4%
Vermont$222$1,2771796-44.5%
South Dakota$216$1,26120104-46.0%

⚠️ 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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