Urology

Revenue benchmarks for Urology practices. E&M coding optimization, care management opportunities, and procedure-adjacent billing.

$76K

Avg Missed/Year

13K

US Providers

500

Avg Patients

2.5

Avg Chronic Dx

Specialty Overview

Urology practices manage a large Medicare patient base (500 avg) with moderate chronic disease complexity. E&M coding optimization is the primary revenue opportunity, as many urology visits for complex conditions like prostate cancer management and recurrent UTIs support higher MDM levels than typically coded.

Key Insight: Urology sees 500 Medicare patients on average — the 3rd highest volume of any specialty. Even small E&M coding improvements across that volume create outsized revenue impact.

E&M Coding Distribution

National benchmark for Urology E&M code distribution. Compare your practice against these targets to identify coding optimization opportunities.

99213

32%

$92/visit

99214

48%

$130/visit

99215

20%

$176/visit

Revenue Gap Breakdown

#1

E&M Coding Gap

$30.6K/yr

32% 99213 usage is high for a specialty managing cancer and complex surgical follow-ups. Benchmark: 32% 99213 / 48% 99214 / 20% 99215.

#2

CCM (99490)

$22.4K/yr

7% adoption. Patients with BPH plus hypertension or diabetes qualify for CCM.

#3

RPM (99453-99458)

$12.4K/yr

Post-surgical monitoring and chronic condition management via RPM. 4% adoption.

#4

AWV (G0438/G0439)

$6.8K/yr

10% AWV rate. PSA screening discussion is a natural AWV add-on.

#5

BHI (99484)

$4.0K/yr

Prostate cancer diagnosis frequently triggers depression and anxiety. 14% prevalence.

Care Management Adoption Rates

CCM

7%

Target: 15%

RPM

4%

Target: 10%

BHI

2%

Target: 10%

AWV

10%

Target: 70%

Common Chronic Conditions

Hypertension (52%)Diabetes (28%)Depression (14%)Heart Failure (10%)COPD (8%)

Urology Provider? See Your Gaps

These are national averages. Scan your NPI to see how your billing compares to Urology benchmarks and get a personalized revenue roadmap.

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