Urology · Louisiana

Urology commercial reimbursement in Louisiana

How Louisiana urology rates compare with the national market.

Urology in Louisiana

37 codes · 104 sampled providers
Index vs national
83
17% below
Rank among states
46 of 50
1 = highest
Codes above national
0 of 37
median code at 83%
Providers
104
sampled

What the data shows

1

Urology ranks 46th of 50 states in Louisiana with an index of 83 (100 = the specialty's national median), across 37 codes and 104 sampled providers.

2

Of the 37 urology codes with enough data in Louisiana, 0 pay above the national median and 37 below; the typical code sits at 83% of the national median.

3

Largest premium over the national median: CPT 52356 (Cysto/uretero w/lithotripsy) at 94%; largest discount: CPT 74178 (Ct abd&plv wo cntr flwd cntr) at 73%.

4

Measured against Medicare, Louisiana urology rates have a median of 140% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeLouisianaNationalGapProv.
52356
Cysto/uretero w/lithotripsy
$615$657-6%104
52224
Cystoscopy and treatment
$421$459-8%102
52601
Prostatectomy (turp)
$1,084$1,181-8%104
64566
Neuroeltrd stim post tibial
$63$69-9%102
55874
Tprnl plmt biodegrdabl matrl
$233$257-9%101

Lowest vs national

CodeLouisianaNationalGapProv.
74178
Ct abd&plv wo cntr flwd cntr
$362$498-27%104
76775
Us exam abdo back wall lim
$69$92-25%103
99490
Chrnc care mgmt staff 1st 20
$45$60-25%102
76857
Us exam pelvic limited
$57$75-24%104
51720
Treatment of bladder lesion
$86$111-23%102

All urology codes in Louisiana

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeLouisianaNationalGap% of MedicareProvidersTINsLevel
CPT 52356
Cysto/uretero w/lithotripsy
$615$657-6%168%104129
CPT 52224
Cystoscopy and treatment
$421$459-8%240%102127
CPT 52601
Prostatectomy (turp)
$1,084$1,181-8%206%104128
CPT 64566
Neuroeltrd stim post tibial
$63$69-9%243%102125
CPT 55874
Tprnl plmt biodegrdabl matrl
$233$257-9%164%101120
CPT 52649
Prostate laser enucleation
$1,223$1,355-10%186%102127
CPT 55866
Laps surg prst8ect rpbic rad
$2,018$2,237-10%187%104128
CPT 51729
Cystometrogram w/vp&up
$494$554-11%140%103128
CPT 52332
Cystoscopy and treatment
$318$360-12%228%104130
CPT 51728
Cystometrogram w/vp
$459$520-12%136%102129
CPT 51702
Insert temp bladder cath
$54$61-12%236%104129
CPT 20610
Drain/inj joint/bursa w/o us
$75$86-12%110%104129
CPT 51798
Us urine capacity measure
$19$21-12%147%101117
CPT 50590
Fragmenting of kidney stone
$930$1,065-13%122%103130
CPT 52000
Cystourethroscopy
$183$210-13%258%104131
CPT 93000
Electrocardiogram complete
$22$26-15%143%104129
CPT 51700
Irrigation of bladder
$65$77-16%248%103130
CPT 52310
Cystoscopy and treatment
$264$317-17%196%103130
CPT 76770
Us exam abdo back wall comp
$127$153-17%119%104128
CPT 76856
Us exam pelvic complete
$122$148-18%116%104129
CPT 99203
Office o/p new low 30 min
$103$125-18%87%104130
CPT 99204
Office o/p new mod 45 min
$161$197-18%91%104130
CPT 52648
Laser surgery of prostate
$1,231$1,508-18%233%102128
CPT 52287
Cystoscopy chemodenervation
$299$367-19%201%104129
CPT 76872
Us transrectal
$153$188-19%127%104130
CPT 99426
Prin care mgmt staff 1st 30
$62$77-19%92%102126
CPT 99205
Office o/p new hi 60 min
$204$257-20%86%104130
CPT 99212
Office o/p est sf 10 min
$41$52-21%70%104130
CPT 52281
Cystoscopy and treatment
$265$334-21%194%102127
CPT 99214
Office o/p est mod 30 min
$106$134-21%78%104130
CPT 99213
Office o/p est low 20 min
$72$92-22%75%104130
CPT 99215
Office o/p est hi 40 min
$144$187-23%75%104130
CPT 51720
Treatment of bladder lesion
$86$111-23%225%102127
CPT 76857
Us exam pelvic limited
$57$75-24%111%104130
CPT 99490
Chrnc care mgmt staff 1st 20
$45$60-25%68%102127
CPT 76775
Us exam abdo back wall lim
$69$92-25%114%103126
CPT 74178
Ct abd&plv wo cntr flwd cntr
$362$498-27%107%104128

Frequently asked questions

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

Louisiana ranks 46th of 50 states with an index of 83; 0 of 37 codes are above the national median.

Which urology code has the biggest premium in Louisiana?

CPT 52356 (Cysto/uretero w/lithotripsy), at 94% 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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