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See a sample rate comparisonCPT 53410 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Urethroplas,1 Stg Recon-Male Urethr
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 53410 |
| Medicaid Fee Schedule | View Medicaid rates for 53410 |
National average reimbursement for CPT 53410 by major payers:
$1,206.12
$1,317.04
$1,451.53
$1,597.77
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CPT 53410
5 of 25 sample ratesHigher to lower in this preview
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis, Prevea Surgery Center
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis
$5,859.00Published rateBraselton Endoscopy Center, LLC
Braselton Endoscopy Center LLC
$3,500.00Published rateParkside Surgery Center, LLC
Parkside Surgery Center
$2,080.00Published rateCpm Surgery Center LLC
$1,500.00Published rateYuma Endoscopy Center
Yuma Endoscopy Center, LLC
$550.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 53410 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53410 code is part of the Surgery services used for Surgical Procedures on the Urinary System. 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 53410 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 |
|---|---|---|
| 53000-CPT | Low | Urethrotomy Or Urethrostomy Xtrnal (Sepa Proc); Pendulous, Urethrotomy Or Urethrostomy External (Separate Procedure); Pendulous |
| 53200-CPT | Moderate | Biopsy Of Urethra |
| 53400-CPT | High | Urethroplasty; First Stage For Fistula Dverticulum Or Stricture, Urethroplasty; First Stage For Fistula Diverticulum Or Stricture (E |
| 53410-CPT | High | Urethroplas,1 Stg Recon-Male Urethr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53410. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53410 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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