Urology · Maryland

Urology commercial reimbursement in Maryland

How Maryland urology rates compare with the national market.

Urology in Maryland

37 codes · 104 sampled providers
Index vs national
96
4% below
Rank among states
29 of 50
1 = highest
Codes above national
9 of 37
median code at 97%
Providers
104
sampled

What the data shows

1

Urology ranks 29th of 50 states in Maryland with an index of 96 (100 = the specialty's national median), across 37 codes and 104 sampled providers.

2

Of the 37 urology codes with enough data in Maryland, 9 pay above the national median and 28 below; the typical code sits at 97% of the national median.

3

Largest premium over the national median: CPT 76872 (Us transrectal) at 104%; largest discount: CPT 52224 (Cystoscopy and treatment) at 60%.

4

Measured against Medicare, Maryland urology rates have a median of 155% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMarylandNationalGapProv.
76872
Us transrectal
$196$188+4%102
51729
Cystometrogram w/vp&up
$568$554+2%101
99212
Office o/p est sf 10 min
$53$52+2%103
52356
Cysto/uretero w/lithotripsy
$670$657+2%103
99213
Office o/p est low 20 min
$93$92+0%103

Lowest vs national

CodeMarylandNationalGapProv.
52224
Cystoscopy and treatment
$273$459-40%102
76857
Us exam pelvic limited
$51$75-31%102
51700
Irrigation of bladder
$55$77-29%103
51702
Insert temp bladder cath
$44$61-28%103
76770
Us exam abdo back wall comp
$112$153-27%102

All urology codes in Maryland

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMarylandNationalGap% of MedicareProvidersTINsLevel
CPT 76872
Us transrectal
$196$188+4%163%102112
CPT 51729
Cystometrogram w/vp&up
$568$554+2%160%101110
CPT 99212
Office o/p est sf 10 min
$53$52+2%90%103112
CPT 52356
Cysto/uretero w/lithotripsy
$670$657+2%183%103116
CPT 99213
Office o/p est low 20 min
$93$92+1%97%103114
CPT 99490
Chrnc care mgmt staff 1st 20
$60$60+0%91%102115
CPT 99205
Office o/p new hi 60 min
$257$257+0%109%103112
CPT 99204
Office o/p new mod 45 min
$198$197+0%111%103112
CPT 51798
Us urine capacity measure
$21$21+0%168%101102
CPT 76775
Us exam abdo back wall lim
$92$92+0%152%102109
CPT 99203
Office o/p new low 30 min
$125$125-0%106%103112
CPT 52601
Prostatectomy (turp)
$1,177$1,181-0%224%103113
CPT 99426
Prin care mgmt staff 1st 30
$76$77-1%112%101111
CPT 99215
Office o/p est hi 40 min
$186$187-1%97%103112
CPT 52310
Cystoscopy and treatment
$313$317-1%233%103113
CPT 99214
Office o/p est mod 30 min
$131$134-2%97%103112
CPT 55874
Tprnl plmt biodegrdabl matrl
$252$257-2%177%102114
CPT 55866
Laps surg prst8ect rpbic rad
$2,186$2,237-2%202%103117
CPT 52281
Cystoscopy and treatment
$322$334-3%236%103113
CPT 76856
Us exam pelvic complete
$142$148-4%135%102110
CPT 51728
Cystometrogram w/vp
$497$520-5%147%101111
CPT 52000
Cystourethroscopy
$200$210-5%281%103113
CPT 52649
Prostate laser enucleation
$1,277$1,355-6%194%102115
CPT 50590
Fragmenting of kidney stone
$1,001$1,065-6%132%102116
CPT 64566
Neuroeltrd stim post tibial
$64$69-7%247%102115
CPT 74178
Ct abd&plv wo cntr flwd cntr
$439$498-12%130%103109
CPT 52332
Cystoscopy and treatment
$300$360-17%215%103116
CPT 52648
Laser surgery of prostate
$1,237$1,508-18%234%102111
CPT 52287
Cystoscopy chemodenervation
$300$367-18%202%102116
CPT 20610
Drain/inj joint/bursa w/o us
$68$86-21%98%104115
CPT 93000
Electrocardiogram complete
$20$26-23%129%102113
CPT 51720
Treatment of bladder lesion
$83$111-25%218%103112
CPT 76770
Us exam abdo back wall comp
$112$153-27%106%102106
CPT 51702
Insert temp bladder cath
$44$61-28%193%103116
CPT 51700
Irrigation of bladder
$55$77-29%212%103115
CPT 76857
Us exam pelvic limited
$51$75-31%100%102110
CPT 52224
Cystoscopy and treatment
$273$459-40%155%102112

Frequently asked questions

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

Maryland ranks 29th of 50 states with an index of 96; 9 of 37 codes are above the national median.

Which urology code has the biggest premium in Maryland?

CPT 76872 (Us transrectal), at 104% 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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