Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 53415 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.
Urethroplasty Transpubic Or P, Urethroplasty Transpubic Or Perineal One Stage Forreconstruction Or Repair Of Prostatic Or Membranous Urethra
| 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 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 53415 |
| Medicaid Fee Schedule | View Medicaid rates for 53415 |
National average reimbursement for CPT 53415 by major payers:
$1,380.27
$1,519.15
$1,645.92
$1,841.06
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 53415.
CPT 53415
5 of 25 sample ratesHigher to lower in this preview
Disc Surgery Center At Marina Del Rey LLC
$15,000.00Published rateRsc Illinois LLC, Regional Surgicenter
$5,354.00Published ratePremier-Covenant Astc LLC, Premier Ambulatory Surgery Center
Premiercovenant Astc LLC
$2,697.00Published rateNorthern Arizona Surgicenter, LLC
Northern Arizona Surgicenter LLC
$1,600.00Published rateTranssouth Health Care PLLC, Transsouth Health Care PC
Transsouth Health Care, P.C.
$948.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 53415 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53415 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 53415 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 |
|---|---|---|
| 53400-CPT | High | Urethroplasty; First Stage For Fistula Dverticulum Or Stricture, Urethroplasty; First Stage For Fistula Diverticulum Or Stricture (E |
| 53405-CPT | High | Urethroplasty; Second Stage (Formation Of Urethra) Inclu Urinary, Urethroplasty; Second Stage (Formation Of Urethra) Including Urinary |
| 53410-CPT | High | Urethroplas,1 Stg Recon-Male Urethr |
| 53415-CPT | High | Urethroplasty Transpubic Or P, Urethroplasty Transpubic Or Perineal One Stage Forreconstruction Or Repair Of Prostatic Or Membranous Urethra |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53415 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 53415) and we'll show you how you compare in 15 minutes or less.