Cysto flx rmv&rplc urtl scaf
Cystoscopy with flexible urethral scaffold removal and replacement (CPT 0942T) lacks established Medicare rates, making hospital billing variations unpredictable and requiring immediate verification of your charges.
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
This procedure uses a flexible scope to remove and replace a temporary scaffold placed in the urethra, typically performed on patients who previously had urethral reconstruction surgery. The procedure is commonly billed for patients with urethral strictures or trauma requiring staged surgical repair. Code 0942T is a Category III CPT code, meaning reimbursement rates vary significantly between payers and prior authorization is often required.
Non-facility rate
$99
Office setting benchmark
Data sources
2
21 data points
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Non-facility (office) | $99 | Lowest |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Data: Federal physician fee schedules, hospital payment data, surgery center rates, lab fee schedules, and drug pricing data. FY 2024. All publicly available from federal sources.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use