52310

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope

Medicare pricing data for 12,108 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $145 in North Dakota to $465 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

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope (HCPCS code 52310) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $303.06, but hospitals typically charge $1,169 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$60.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $303.06, your out-of-pocket cost would be approximately $60.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$303.06
Average Hospital Charge
$1,169
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,169.37
Medicare Allowed$303.06
Medicare Payment$238.21

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $238.21 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$465$2,3902333,725+53.5%
Hawaii$397$1,40724121+30.9%
South Dakota$376$1,44536887+23.9%
Colorado$375$2,2822451,992+23.8%
Kentucky$370$1,6691221,318+22.2%
Nebraska$370$1,317901,413+22.0%
Oregon$365$1,2541521,464+20.4%
Georgia$355$1,5353583,103+17.1%
New Jersey$353$1,9444292,743+16.4%
Pennsylvania$336$9695665,414+10.8%
Mississippi$328$1,2741111,480+8.1%
Florida$325$1,0799377,553+7.1%
Alaska$323$2,96731154+6.5%
New York$321$1,2647555,310+6.0%
District of Columbia$318$88639342+4.9%
Nevada$311$91374529+2.6%
Wyoming$309$96116138+2.0%
Arizona$309$1,1222862,693+1.8%
Massachusetts$305$1,3923142,577+0.6%
California$303$1,1009215,7410.0%
Puerto Rico$301$4292026-0.7%
Kansas$296$9781261,445-2.5%
Rhode Island$295$74547260-2.7%
Virginia$286$9123141,980-5.7%
Connecticut$285$1,381149901-6.0%
Tennessee$283$9852772,323-6.6%
Washington$280$7462482,134-7.8%
Illinois$279$1,1594853,941-7.9%
Texas$273$9167924,480-9.8%
Ohio$271$9535034,154-10.5%
Missouri$271$8412932,073-10.7%
South Carolina$270$9442191,808-11.0%
Utah$264$792103866-12.8%
North Carolina$262$8444112,664-13.6%
Alabama$259$620158772-14.4%
Minnesota$259$1,2082581,538-14.5%
Delaware$259$95246361-14.7%
Michigan$256$6943602,310-15.6%
Oklahoma$251$6051671,177-17.1%
Indiana$243$1,0053222,183-19.7%
Arkansas$243$674112861-20.0%
Louisiana$237$9111941,158-21.8%
New Mexico$236$72644286-22.1%
Idaho$235$58957526-22.4%
Wisconsin$228$1,8362361,790-24.9%
Iowa$226$929130918-25.4%
New Hampshire$222$99860585-26.9%
Montana$195$46451344-35.5%
West Virginia$168$1,06159433-44.7%
Maine$164$45469435-45.7%
Vermont$155$39526269-48.8%
North Dakota$145$76217356-52.0%

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