CPT 51720: Intravesical Anticarcinogenic Instillation for Bladder Cancer
Medicare pays $95 and commercial payers pay $332 on average nationally for this procedure.
CPT code 51720 describes intravesical instillation of an anticarcinogenic agent for bladder cancer, delivered through a urinary catheter and retained in the bladder for a specified dwell time before drainage; this is a procedural treatment service typically performed in an outpatient urology clinic or ambulatory surgical center using short-duration catheter-based bladder instillation techniques.
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National Reimbursement Benchmarks
Medicare’s mean rate of $95 sits well below BUCA’s average commercial mean of $331.9, indicating a substantial premium in commercial contracting versus the federal program for CPT 51720. The gap highlights how commercial payers can reimburse multiple times higher than Medicare, with BUCA’s mean approximately $236.9 higher than Medicare’s mean.
Dispersion varies across payers: Blue Cross Blue Shield shows the widest interquartile spread with P75−P25 = $200. -calculation yields $616.2 − $416.3 = $200.0, while Aetna and UnitedHealth Group exhibit tighter spreads of $59.0 and $85.7 respectively (Aetna: $95.8 − $39.0 = $56.8; UnitedHealth Group: $169.6 − $84.3 = $85.3). Cigna’s IQR is $84.5 ($160.8 − $73.6) and BUCA’s is $147.7 ($413.0 − $265.3). These differences reflect varying pricing consistency across payers.