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 |
| Medicare Fee Schedule | View Medicare rates for 0054T |
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 | $3031.00 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $3031.00 | 1700801909 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $414.67 | 1902855901 - BIG SPRING VAMC | 752510465 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1969.00 | 1649273434 - BAYLOR REGIONAL MEDICAL CENTER AT PLANO, BAYLOR SCOTT & WHITE MEDICAL CENTER - PLANO | 820551704 - (TX) BAYLOR REGIONAL MEDICAL CENTER AT PLANO | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1107.00 | 1851390967 - UHS OF TEXOMA, INC, TEXOMA MEDICAL CENTER | 205908627 - UHS OF TEXOMA INC | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1824.00 | 1023063914 - EL PASO HEALTHCARE SYSTEM LTD, LAS PALMAS DEL SOL HEALTHCARE | 742499952 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1201.00 | 1619115383 - ASCENSION SETON, ASCENSION SETON HAYS | 741109643 - ASCENSION SETON | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $381.00 | 1972590602 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL | 751256948 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $64.00 | 1477698454 - REGIONAL EYE SURGERY CENTER,LLC | 721484653 - (LA) REGIONAL EYE SURGERY CENTER, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 0054T | $1085.00 | 1770514077 - TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO | 752770738 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $1400.00 | 1003883158 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON, TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON | 432008974 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON | TX | 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 | $660.00 | 1295843753 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 0054T | $421.00 | 1558492546 - LYNN COUNTY HOSPITAL DISTRICT, LCHD - FAMILY WELLNESS CLINIC | 751328354 - (TX) LYNN COUNTY HOSPITAL DISTRICT | 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 | 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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