CPT 53450 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53450 |
National average reimbursement for CPT 53450 by major payers:
$515.05
$547.23
$605.46
$685.20
| 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 53450 | ||||||
United | 53450 | $1200.00 | 1184682445 - PORTSMOUTH SURGERY CENTER | 743085624 - (OH) PORTSMOUTH SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $1098.00 | 1285283432 - JONESBORO AMBULATORY SURGERY CENTER, LLC | 832479059 - (AR) JONESBORO AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $733.78 | 1467042804 - MARIA KLOPFENSTEIN | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 53450 | $945.00 | 1447366224 - WEST MICHIGAN SURGERY CENTER, LLC | 371509502 - (MI) MICHIGAN PRIMARY CARE PARTNERS PC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $897.00 | 1639242506 - RENAL INTERVENTION CENTER, LLC | 371387622 - (IL) RENAL INTERVENTION CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $1160.00 | 1538110713 - CENTER FOR DIGESTIVE HEALTH LLC | 201606438 - (MS) CENTER FOR DIGESTIVE HEALTH LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $819.00 | 1710213400 - VISION SURGERY CENTER, LLC | 371579446 - (OH) VISION SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $1246.00 | 1205853041 - EUCLID ENDOSCOPY CENTER, LP | 203197449 - (CA) EUCLID ENDOSCOPY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $2267.00 | 1891286860 - SANDY SPRINGS CENTER FOR UROLOGIC SURGERY LLC | 825437441 - (GA) SANDY SPRINGS CENTER FOR UROLOGIC SURGERY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $2220.00 | 1093230450 - CENTER FOR UROLOGIC SURGERY LLC | 822344535 - (MO) CENTER FOR UROLOGIC SURGERY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $641.00 | 1649244567 - LAKELAND FL ENDOSCOPY ASC LLC, SURGERY CENTER OF LAKELAND HILLS BOULEVARD | 200288888 - (FL) LAKELAND FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $2070.00 | 1316191430 - LAREDO DIGESTIVE HEALTH CENTER LLC | 261286495 - (TX) LAREDO DIGESTIVE HEALTH CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $3623.00 | 1023349909 - PICCARD SURGERY CENTER, LLC | 270433723 - (MD) PICCARD SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $2010.00 | 1194326785 - TEXAS PARTNERS CENTER LLC | 853236752 - (TX) TEXAS PARTNERS CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53450 | $2055.00 | 1255309803 - G S S C LTD PARTNERSHIP | 680343818 - (CA) GSSC LTD PARTNERSHIP DBA GREATER SACRAMENTO SURGERY CENTER | 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 53450 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53450 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 53450 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 |
|---|---|---|
| 53425-CPT | High | Urethroplasty Stg 2 |
| 53450-CPT | Moderate | Urethromeatoplasty W Mucosal Advanc |
| 53451-CPT | High | Periurethral Transperineal Adjustable Balloon Continence Device; Bilateral Insertion Including Cystourethroscopy And Imaging Guidance |
| 53452-CPT | High | Periurethral Transperineal Adjustable Balloon Continence Device; Unilateral Insertion, Including Cystourethroscopy And Imaging Guidance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53450. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53450 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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