Urology · Connecticut

Urology commercial reimbursement in Connecticut

How Connecticut urology rates compare with the national market.

Urology in Connecticut

37 codes · 116 sampled providers
Index vs national
115
15% above
Rank among states
13 of 50
1 = highest
Codes above national
35 of 37
median code at 115%
Providers
116
sampled

What the data shows

1

Urology ranks 13th of 50 states in Connecticut with an index of 115 (100 = the specialty's national median), across 37 codes and 116 sampled providers.

2

Of the 37 urology codes with enough data in Connecticut, 35 pay above the national median and 2 below; the typical code sits at 115% of the national median.

3

Largest premium over the national median: CPT 74178 (Ct abd&plv wo cntr flwd cntr) at 174%; largest discount: CPT 99212 (Office o/p est sf 10 min) at 97%.

4

Measured against Medicare, Connecticut urology rates have a median of 211% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeConnecticuNationalGapProv.
74178
Ct abd&plv wo cntr flwd cntr
$868$498+74%111
93000
Electrocardiogram complete
$35$26+36%115
51729
Cystometrogram w/vp&up
$746$554+35%116
51728
Cystometrogram w/vp
$692$520+33%116
55874
Tprnl plmt biodegrdabl matrl
$340$257+32%116

Lowest vs national

CodeConnecticuNationalGapProv.
99212
Office o/p est sf 10 min
$51$52-3%115
99213
Office o/p est low 20 min
$91$92-1%115
99203
Office o/p new low 30 min
$126$125+1%115
52224
Cystoscopy and treatment
$474$459+3%116
64566
Neuroeltrd stim post tibial
$72$69+3%116

All urology codes in Connecticut

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeConnecticutNationalGap% of MedicareProvidersTINsLevel
CPT 74178
Ct abd&plv wo cntr flwd cntr
$868$498+74%257%111114
CPT 93000
Electrocardiogram complete
$35$26+36%227%115125
CPT 51729
Cystometrogram w/vp&up
$746$554+35%211%116129
CPT 51728
Cystometrogram w/vp
$692$520+33%205%116132
CPT 55874
Tprnl plmt biodegrdabl matrl
$340$257+32%238%116129
CPT 52649
Prostate laser enucleation
$1,787$1,355+32%272%116130
CPT 52601
Prostatectomy (turp)
$1,535$1,181+30%292%116132
CPT 52356
Cysto/uretero w/lithotripsy
$853$657+30%234%116134
CPT 51720
Treatment of bladder lesion
$141$111+27%371%116131
CPT 20610
Drain/inj joint/bursa w/o us
$106$86+24%154%115128
CPT 50590
Fragmenting of kidney stone
$1,301$1,065+22%171%116132
CPT 55866
Laps surg prst8ect rpbic rad
$2,690$2,237+20%249%116131
CPT 52000
Cystourethroscopy
$252$210+20%354%116133
CPT 52310
Cystoscopy and treatment
$379$317+19%282%116135
CPT 76872
Us transrectal
$222$188+18%184%114125
CPT 99490
Chrnc care mgmt staff 1st 20
$70$60+17%106%115125
CPT 51700
Irrigation of bladder
$89$77+16%343%116131
CPT 52648
Laser surgery of prostate
$1,742$1,508+15%330%116130
CPT 52287
Cystoscopy chemodenervation
$422$367+15%283%116132
CPT 52281
Cystoscopy and treatment
$381$334+14%279%116132
CPT 76770
Us exam abdo back wall comp
$173$153+13%163%112117
CPT 99426
Prin care mgmt staff 1st 30
$86$77+12%127%114123
CPT 76856
Us exam pelvic complete
$162$148+9%154%114124
CPT 51702
Insert temp bladder cath
$66$61+8%290%116131
CPT 52332
Cystoscopy and treatment
$389$360+8%279%116134
CPT 76857
Us exam pelvic limited
$79$75+6%155%114125
CPT 51798
Us urine capacity measure
$23$21+6%177%110109
CPT 99215
Office o/p est hi 40 min
$197$187+5%102%115134
CPT 76775
Us exam abdo back wall lim
$97$92+5%160%114126
CPT 99205
Office o/p new hi 60 min
$269$257+5%114%115133
CPT 99214
Office o/p est mod 30 min
$140$134+5%103%115134
CPT 99204
Office o/p new mod 45 min
$206$197+5%116%115134
CPT 64566
Neuroeltrd stim post tibial
$72$69+3%275%116128
CPT 52224
Cystoscopy and treatment
$474$459+3%270%116131
CPT 99203
Office o/p new low 30 min
$126$125+1%108%115134
CPT 99213
Office o/p est low 20 min
$91$92-1%96%115134
CPT 99212
Office o/p est sf 10 min
$51$52-3%86%115134

Frequently asked questions

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

Connecticut ranks 13th of 50 states with an index of 115; 35 of 37 codes are above the national median.

Which urology code has the biggest premium in Connecticut?

CPT 74178 (Ct abd&plv wo cntr flwd cntr), at 174% 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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