CPT 53440 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 53440 |
National average reimbursement for CPT 53440 by major payers:
$1,003.45
$1,051.42
$1,118.40
$1,294.30
| 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 53440 | ||||||
United | 53440 | $10500.00 | 1306438007 - COMPREHENSIVE SURGICAL CARE OF GILBERT, LLC | 852825570 - (AZ) COMPREHENSIVE SURGICAL CARE OF GILBERT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $6195.00 | 1013468586 - LAKEWAY AMBULATORY SURGERY CENTER, LLC, LAKEWAY SURGERY CENTER | 383992761 - (TX) LAKEWAY AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $4140.00 | 1922211192 - VOORHEES SURGERY CENTER, LLC | 651203770 - (NJ) VOORHEES SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $3000.00 | 1659505857 - HASBROUCK HEIGHTS SURGERY CENTER, LLC | 264379508 - (NJ) HASBROUCK HEIGHTS SURGERY CENT | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $11558.00 | 1104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER | 205537270 - (TX) NORTHWEST SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $1535.00 | 1275564346 - CEDAR OAKS SURGERY CENTER LLC | 450528697 - (MO) CEDAR OAKS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $4415.93 | 1033190129 - MAE PHYSICIANS SURGERY CENTER, LLC | 640914895 - (MS) MAE PHYSICIAN'S SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $3820.00 | 1760414056 - VAN DYCK ASC, LLC | 621817203 - (TN) VAN DYCK ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $9650.00 | 1811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER | 814378043 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $6760.00 | 1477527398 - TEMECULA CA ENDOSCOPY ASC LP, TEMECULA VALLEY ENDOSCOPY CENTER | 200095307 - (CA) TEMECULA CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $9510.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $6500.00 | 1588994685 - SOUTHEASTERN INTERVENTIONAL PAIN ASC LLC | 271651377 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $16523.00 | 1902052350 - SURGERY CENTER, LLC | 263169180 - (WI) THE SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $990.00 | 1225070527 - LIBERTY CATARACT CENTER LLC | 743099283 - (MO) LIBERTY CATARACT CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $6037.00 | 1801974720 - SUMMIT SURGICAL CENTER, LLC | 731730859 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 53440 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53440 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 53440 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 |
|---|---|---|
| 53440-CPT | High | Rep Incontinence Urinary Male |
| 53442-CPT | High | Remov Perineal Prosth.For Continenc |
| 53445-CPT | High | Operation For Correction Of Urinary Incontinence With Placement Of Inflatable Urethral Or Bladder Neck Sphincter, Includ |
| 53446-CPT | Moderate | Removal Of Inflatable Urethral/Bladder Neck Sphincter, Including Pump, Reservoir, And Cuff |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53440. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53440 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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