CPT 0054T Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Category III Codes • Various Services - Category III Codes |
| Complexity Level | Moderate |
National average reimbursement for CPT 0054T by major payers:
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| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 0054T | ||||||
United | 0054T | $1824.00 | 1023063914 - EL PASO HEALTHCARE SYSTEM LTD, LAS PALMAS DEL SOL HEALTHCARE | 742499952 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1547.00 | 1376071530 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., LLP, METHODIST HOSPITAL ATASCOSA | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1772.00 | 1447597240 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $4597.00 | 1982666111 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN HOSPITAL | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $630.00 | 1851632616 - LANCASTER REGIONAL HOSPITAL, LP, CRESCENT MEDICAL CENTER LANCASTER | 273815440 - (TX) LANCASTER REGIONAL HOSPITAL, LP | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1652.00 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $400.69 | 1790777696 - JACK COUNTY HOSPITAL DISTRICT, FAITH COMMUNITY HOSPITAL | 756004585 - (TX) FAITH COMMUNITY HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1400.00 | 1174533343 - TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $996.00 | 1689641680 - CHRISTUS SPOHN HEALTH SYSTEM CORPORATION, CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI | 741109836 - (TX) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $4867.00 | 1952497489 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 0054T | $204.00 | 1366506826 - AMERICAN LEGION HOSPITAL | 464958152 - (LA) ACADIA GENERAL HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | 0054T | $820.00 | 1912909912 - BRFHH SHREVEPORT LLC, UNIVERSITY HEALTH SHREVEPORT | 831173631 | LA | General Acute Care Hospital (282N00000X) |
United | 0054T | $2059.00 | 1679528889 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1400.00 | 1629064928 - SOUTHLAKE SPECIALTY HOSPITAL, LLC, TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHLAKE | 20555370 - (TX) SOUTHLAKE SPECIALTY HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1477.00 | 1023065794 - CHCA WOMANS HOSPITAL LP, WOMAN'S HOSPITAL OF TEXAS | 621810381 - (TX) CHCA WOMANS HOSPITAL LP | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 0054T vs. Other Various Services - Category III Codes Codes
The CPT 0054T code is part of the Category III Codes services used for Various Services - Category III Codes. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 0054T code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 0054T-CPT | Moderate | Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure, With Image-Guidance Based On Fluoroscopic Images (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0054T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0054T fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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