CPT 53453 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 • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 53453 |
National average reimbursement for CPT 53453 by major payers:
$1,279.77
$857.47
$681.13
$857.06
| 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 53453 | ||||||
United | 53453 | $2859.00 | 1619637543 - GAB ENDOSCOPY CENTER LLC | 372021101 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $2206.00 | 1821453796 - MASON RIDGE AMBULATORY SURGERY CENTER LP, GATEWAY ENDOSCOPY CENTER | 205953364 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $390.00 | 1023134640 - LOCUST GROVE ENDO CENTER | 205860757 - (GA) LOCUST GROVE ENDO CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $614.00 | 1295131001 - OPTUMCARE COLORADO ASC, LLC, COLORADO SPRINGS HEALTH PARTNERS ASC, LLC | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $1645.00 | 1083299747 - IRVING SPECIALISTS SURGICAL CENTER LLC | 852271899 - (TX) IRVING SPECIALISTS SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $2025.00 | 1760963292 - COLONIAL OUTPATIENT SURGERY CENTER, LLC | 831529015 - (FL) COLONIAL OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $1459.00 | 1982978466 - NORTHWEST ENT SURGERY CENTER, LLC | 453307193 - (GA) NORTHWEST ENT SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $2388.00 | 1558618116 - TAVARES SURGERY LLC | 300728155 - (FL) TAVARES SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $1340.00 | 1922316835 - INDEPENDENT SURGERY CENTER LLC | 272764590 - (WI) INDEPENDENT SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $1350.00 | 1235132481 - CYPRESS AMBULATORY SURGERY CENTER | 770568944 - (CA) CYPRESS AMBULATORY SURGERY CEN | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $3680.00 | 1992058325 - SOUTH BEND SPECIALTY SURGERY CENTER, LLC | 460571418 - (IN) SOUTH BEND SPECIALTY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $2388.00 | 1396919783 - SURGCENTER OF SOUTHERN MARYLAND, LLC | 261572885 - (MD) SURGCENTER OF SOUTHERN MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $1150.00 | 1780752352 - PREMIER SURGERY CENTER OF SANTA MARIA LLC | 203502741 - (CA) PREMIER SURGERY CENTER OF SANTA MARIA, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $5982.00 | 1477140796 - PORTSMOUTH SURGICENTER, LLC | 833659705 - (NH) PORTSMOUTH SURGICENTER LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53453 | $2206.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | 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 53453 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53453 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 53453 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 |
|---|---|---|
| 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 |
| 53453-CPT | High | Periurethral Transperineal Adjustable Balloon Continence Device; Removal Each Balloon |
| 53454-CPT | Low | Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53453. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53453 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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