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 |
| CMS | $732.33 Physician Fee Schedule |
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 | $4506.00 | 1043497019 - PIKESVILLE MD ENDOSCOPY ASC LLC, ENDOCENTRE OF BALTIMORE | 261467040 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $3479.00 | 1366412710 - MEREDYTH SURGERY CENTER, PC | 593793678 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $2176.00 | 1770532194 - BROADWEST SPECIALTY SURGICAL CENTER, LLC | 710991736 - (IN) BROADWEST SPECIALTY SURGICAL 401 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $1197.00 | 1407993132 - DIGESTIVE DISEASE ENDOSCOPY CENTER | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $5468.00 | 1669446852 - VOORHEES NJ ENDOSCOPY ASC LLC, THE ENDO CENTER AT VOORHEES | 510446274 - (NJ) THE VOORHEES NJ ENDOSCOPY ASC LLC | NJ | 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 | $5000.00 | 1952852873 - PACIFIC NORTHWEST UROLOGY SPECIALISTS, PLLC, PACIFIC NORTHWEST UROLOGY SURGERY CENTER | 473036836 - (WA) PACIFIC NORTHWEST UROLOGY SPECIALIST, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $7308.00 | 1144333881 - NORTH SCOTTSDALE AMBULATORY SURGERY CENTER, LLC | 200554616 - (AZ) NORTH SCOTTSDALE AMBULATORY SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $11960.00 | 1841295425 - CROSS TIMBERS SURGERY CENTER, LLC, NORTH TEXAS GI CENTER | 752862780 - (TX) CROSS TIMBERS SURGERY CENTER, LP DBA NORTH TEXAS GI CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $3602.00 | 1881699106 - CENTER FOR DAY SURGERY | 621845006 - (TN) CENTER FOR DAY SURGERY | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53440 | $1000.00 | 1831349406 - GASTROENTEROLOGY EAST, P.A. | 202964888 - (NC) GASTROENTEROLOGY EAST, P.A. | NC | 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 | $2040.00 | 1144275900 - MT LAUREL ENDOSCOPY CENTER L P | 562350370 - (NJ) MT LAUREL ENDOSCOPY CENTER L P | 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 | $7368.00 | 1407227358 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT NORTHPOINT | 201796841 | FL | 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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