Urology · Florida

Urology commercial reimbursement in Florida

How Florida urology rates compare with the national market.

Urology Florida

Urology in Florida

37 codes · 112 sampled providers

Index vs national

14% below

Rank among states

43 of 50

1 = highest

Codes above national

0 of 37

median code at 86%

Providers

112

sampled

What the data shows

Urology ranks 43rd of 50 states in Florida with an index of 86 (100 = the specialty's national median), across 37 codes and 112 sampled providers.

Of the 37 urology codes with enough data in Florida, 0 pay above the national median and 37 below; the typical code sits at 86% of the national median.

Largest premium over the national median: CPT 64566 (Neuroeltrd stim post tibial) at 99%; largest discount: CPT 76775 (Us exam abdo back wall lim) at 62%.

Measured against Medicare, Florida urology rates have a median of 136% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

Code	Florida	National	Gap	Prov.
64566 Neuroeltrd stim post tibial	$69	$69	-1%	111
99426 Prin care mgmt staff 1st 30	$74	$77	-4%	111
99205 Office o/p new hi 60 min	$242	$257	-6%	112
99204 Office o/p new mod 45 min	$182	$197	-8%	112
99203 Office o/p new low 30 min	$114	$125	-9%	112

Lowest vs national

Code	Florida	National	Gap	Prov.
76775 Us exam abdo back wall lim	$57	$92	-38%	111
74178 Ct abd&plv wo cntr flwd cntr	$311	$498	-38%	112
76857 Us exam pelvic limited	$48	$75	-36%	112
76770 Us exam abdo back wall comp	$101	$153	-34%	112
76856 Us exam pelvic complete	$98	$148	-34%	111

All urology codes in Florida

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium

Code	Florida	National	Gap	% of Medicare	Providers	TINs
CPT 64566 Neuroeltrd stim post tibial	$69	$69	-1%	264%	111	154
CPT 99426 Prin care mgmt staff 1st 30	$74	$77	-4%	109%	111	151
CPT 99205 Office o/p new hi 60 min	$242	$257	-6%	102%	112	160
CPT 99204 Office o/p new mod 45 min	$182	$197	-8%	103%	112	161
CPT 99203 Office o/p new low 30 min	$114	$125	-9%	97%	112	161
CPT 20610 Drain/inj joint/bursa w/o us	$78	$86	-9%	113%	110	157
CPT 55866 Laps surg prst8ect rpbic rad	$2,015	$2,237	-10%	186%	112	157
CPT 99215 Office o/p est hi 40 min	$168	$187	-10%	87%	112	161
CPT 99214 Office o/p est mod 30 min	$119	$134	-11%	88%	112	161
CPT 52224 Cystoscopy and treatment	$407	$459	-11%	232%	111	154
CPT 51702 Insert temp bladder cath	$53	$61	-12%	235%	112	156
CPT 51729 Cystometrogram w/vp&up	$482	$554	-13%	136%	112	156
CPT 99212 Office o/p est sf 10 min	$45	$52	-13%	76%	112	160
CPT 55874 Tprnl plmt biodegrdabl matrl	$223	$257	-13%	156%	112	154
CPT 52356 Cysto/uretero w/lithotripsy	$565	$657	-14%	155%	112	159
CPT 52601 Prostatectomy (turp)	$1,015	$1,181	-14%	193%	112	158
CPT 51700 Irrigation of bladder	$66	$77	-14%	254%	112	157
CPT 51720 Treatment of bladder lesion	$95	$111	-14%	250%	112	158
CPT 99213 Office o/p est low 20 min	$79	$92	-14%	83%	112	161
CPT 51728 Cystometrogram w/vp	$443	$520	-15%	132%	112	155
CPT 52649 Prostate laser enucleation	$1,149	$1,355	-15%	175%	112	155
CPT 52648 Laser surgery of prostate	$1,277	$1,508	-15%	242%	112	155
CPT 99490 Chrnc care mgmt staff 1st 20	$51	$60	-16%	77%	111	157
CPT 52000 Cystourethroscopy	$176	$210	-16%	248%	112	158
CPT 52287 Cystoscopy chemodenervation	$308	$367	-16%	207%	112	153
CPT 52310 Cystoscopy and treatment	$265	$317	-16%	197%	112	158
CPT 50590 Fragmenting of kidney stone	$889	$1,065	-17%	117%	112	158
CPT 52281 Cystoscopy and treatment	$278	$334	-17%	204%	112	156
CPT 52332 Cystoscopy and treatment	$300	$360	-17%	215%	111	158
CPT 93000 Electrocardiogram complete	$21	$26	-17%	139%	111	156
CPT 51798 Us urine capacity measure	$17	$21	-18%	138%	108	131
CPT 76872 Us transrectal	$136	$188	-28%	113%	112	157
CPT 76856 Us exam pelvic complete	$98	$148	-34%	93%	111	157
CPT 76770 Us exam abdo back wall comp	$101	$153	-34%	95%	112	156
CPT 76857 Us exam pelvic limited	$48	$75	-36%	94%	112	157
CPT 74178 Ct abd&plv wo cntr flwd cntr	$311	$498	-38%	92%	112	152
CPT 76775 Us exam abdo back wall lim	$57	$92	-38%	95%	111	156

Frequently asked questions

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

Florida ranks 43rd of 50 states with an index of 86; 0 of 37 codes are above the national median.

Which urology code has the biggest premium in Florida?

CPT 64566 (Neuroeltrd stim post tibial), at 99% 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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