CPT 53446 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 | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 78 - Return to OR - related procedure • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53446 |
National average reimbursement for CPT 53446 by major payers:
$765.88
$864.52
$917.02
$1,078.48
| 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 53446 | ||||||
United | 53446 | $3275.00 | 1639682503 - SOUTH PLAINS SURGERY CENTER LLC | 822142398 - (TX) SOUTH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $1706.00 | 1891724936 - ARKLAMISS SURGERY CENTER,LLC | 870741444 - (LA) ARKLAMISS SURGERY CENTERLLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $2000.00 | 1205978780 - MOUNTAIN HOME SURGERY CENTER | 454157268 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $4480.00 | 1386161495 - MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC | 820985178 - (MD) MEDSTAR SURGERY CENTER AT BRAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $747.00 | 1588991228 - THE EYE SURGICAL CENTER OF FORT WAYNE, LLC | 271316595 - (IN) THE EYE SURGICAL CENTER OF FORT WAYNE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $3335.00 | 1629135843 - NAEEM M AKHTAR, MADERA AMBULATORY ENDOSCOPY CENTER | 770194609 - (CA) NAEEM M. AKHTAR, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $4703.00 | 1184375545 - MEDPARK SPECIALIZED SURGERY, LLC | 863466448 - (ND) MEDPARK SPECIALIZED SURGERY LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $6376.00 | 1972850808 - LAKE RIDGE AMBULATORY SURGERY CENTER, LLC, LAKE RIDGE SURGERY CENTER | 455347932 - (VA) LAKE RIDGE AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $3475.00 | 1053409896 - MID COUNTY SURGERY CENTER | 200465444 - (MO) MID COUNTY SURGERY CENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $4800.00 | 1033560420 - ABINGDON SURGICAL CENTER PC | 813054896 - (MD) ABINGDON SURGICAL CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $5454.00 | 1083670970 - GLENWOOD SURGICAL CENTER L P | 330595220 - (CA) GLENWOOD SURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $3000.00 | 1235363987 - CORONADO SURGERY CENTER, LLC | 261743406 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $3000.00 | 1487280871 - MARYLAND AMBULATORY SURGERY CENTER LLC | 845098442 - (MD) MARYLAND AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $2377.00 | 1083946149 - METHODIST ENDOSCOPY CENTER LLC | 263765679 - (NE) METHODIST ENDOSCOPY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53446 | $3700.00 | 1134882277 - FVC LONG BEACH ASC LLC, AZURA SURGERY CENTER LONG BEACH | 863649758 - (CA) FVC LONG BEACH ASC LLC | CA | 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 53446 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53446 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 53446 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 53446. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53446 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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