Urology · Alabama

Urology commercial reimbursement in Alabama

How Alabama urology rates compare with the national market.

Urology in Alabama

37 codes · 117 sampled providers
Index vs national
80
20% below
Rank among states
48 of 50
1 = highest
Codes above national
4 of 37
median code at 80%
Providers
117
sampled

What the data shows

1

Urology ranks 48th of 50 states in Alabama with an index of 80 (100 = the specialty's national median), across 37 codes and 117 sampled providers.

2

Of the 37 urology codes with enough data in Alabama, 4 pay above the national median and 33 below; the typical code sits at 80% of the national median.

3

Largest premium over the national median: CPT 52649 (Prostate laser enucleation) at 119%; largest discount: CPT 99204 (Office o/p new mod 45 min) at 60%.

4

Measured against Medicare, Alabama urology rates have a median of 148% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeAlabamaNationalGapProv.
52649
Prostate laser enucleation
$1,612$1,355+19%116
52601
Prostatectomy (turp)
$1,340$1,181+14%117
52356
Cysto/uretero w/lithotripsy
$739$657+12%117
50590
Fragmenting of kidney stone
$1,123$1,065+5%117
52648
Laser surgery of prostate
$1,508$1,508+0%116

Lowest vs national

CodeAlabamaNationalGapProv.
99204
Office o/p new mod 45 min
$118$197-40%117
99205
Office o/p new hi 60 min
$155$257-39%117
99203
Office o/p new low 30 min
$79$125-36%117
99426
Prin care mgmt staff 1st 30
$49$77-36%116
99215
Office o/p est hi 40 min
$122$187-35%117

All urology codes in Alabama

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeAlabamaNationalGap% of MedicareProvidersTINsLevel
CPT 52649
Prostate laser enucleation
$1,612$1,355+19%245%116134
CPT 52601
Prostatectomy (turp)
$1,340$1,181+13%255%117135
CPT 52356
Cysto/uretero w/lithotripsy
$739$657+12%202%117135
CPT 50590
Fragmenting of kidney stone
$1,123$1,065+5%148%117134
CPT 52648
Laser surgery of prostate
$1,508$1,508+0%285%116134
CPT 93000
Electrocardiogram complete
$25$26-1%165%116132
CPT 51798
Us urine capacity measure
$21$21-1%166%113116
CPT 52281
Cystoscopy and treatment
$323$334-3%236%117134
CPT 52332
Cystoscopy and treatment
$348$360-3%249%117135
CPT 76872
Us transrectal
$179$188-5%149%116130
CPT 55866
Laps surg prst8ect rpbic rad
$2,066$2,237-8%191%117134
CPT 76856
Us exam pelvic complete
$133$148-10%127%116131
CPT 52287
Cystoscopy chemodenervation
$330$367-10%221%117134
CPT 76770
Us exam abdo back wall comp
$137$153-10%129%116129
CPT 52310
Cystoscopy and treatment
$284$317-11%211%117135
CPT 76857
Us exam pelvic limited
$65$75-13%127%116131
CPT 52224
Cystoscopy and treatment
$395$459-14%225%116133
CPT 76775
Us exam abdo back wall lim
$78$92-15%129%116129
CPT 52000
Cystourethroscopy
$169$210-20%238%117135
CPT 51702
Insert temp bladder cath
$49$61-20%215%117134
CPT 20610
Drain/inj joint/bursa w/o us
$69$86-20%100%117136
CPT 51728
Cystometrogram w/vp
$413$520-21%123%116130
CPT 51720
Treatment of bladder lesion
$86$111-23%225%116135
CPT 51700
Irrigation of bladder
$59$77-24%225%117134
CPT 51729
Cystometrogram w/vp&up
$417$554-25%118%116130
CPT 74178
Ct abd&plv wo cntr flwd cntr
$373$498-25%110%116128
CPT 99212
Office o/p est sf 10 min
$39$52-25%66%117136
CPT 99214
Office o/p est mod 30 min
$95$134-29%70%117136
CPT 55874
Tprnl plmt biodegrdabl matrl
$180$257-30%126%117133
CPT 99213
Office o/p est low 20 min
$63$92-32%66%117136
CPT 64566
Neuroeltrd stim post tibial
$47$69-32%181%117132
CPT 99490
Chrnc care mgmt staff 1st 20
$41$60-33%61%117135
CPT 99215
Office o/p est hi 40 min
$122$187-35%64%117136
CPT 99426
Prin care mgmt staff 1st 30
$49$77-36%72%116129
CPT 99203
Office o/p new low 30 min
$79$125-36%68%117136
CPT 99205
Office o/p new hi 60 min
$155$257-39%66%117136
CPT 99204
Office o/p new mod 45 min
$118$197-40%66%117136

Frequently asked questions

How do Alabama urology rates compare with the rest of the country?

Alabama ranks 48th of 50 states with an index of 80; 4 of 37 codes are above the national median.

Which urology code has the biggest premium in Alabama?

CPT 52649 (Prostate laser enucleation), at 119% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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