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See a sample rate comparisonCPT 53460 Fee Schedule
Last Verified: October 2026
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.
Urethromeatoplasty W/ Partial Xcision Of Distal Urethral Sgment, Urethromeatoplasty With Partial Excision Of Distal Urethral Segment (
| 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 SG - Scene to Hospital ESRD facility 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53460 |
| Medicaid Fee Schedule | View Medicaid rates for 53460 |
National average reimbursement for CPT 53460 by major payers:
$570.83
$613.37
$649.66
$748.33
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CPT 53460
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Rockwall, LLC
Texas Health Surgery Center Rockwall LLC
$4,141.00Published rateSurgcenter Of Orange Park, LLC, Orange Park Endoscopy Center
Surgcenter Of Orange Park LLC
$2,353.00Published rateAlaska Digestive Center, LLC
Alaska Digestive Center LLC
$1,977.00Published rateOakland Ca Endoscopy Asc Lp, East Bay Endosurgery Center
Oakland Ca Endoscopy Asc Lp
$1,250.00Published ratePatrick A Conarro Md, D.B.A. Summit Surgical Asc
Patrick A Conarro Md
$496.00Published rate
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See a sample payer proposalCPT 53460 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53460 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 53460 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 |
|---|---|---|
| 53450-CPT | Moderate | Repair Opening To Urine Tract, Surgery To Widen Or Reconstruct The Meatus (Opening To The Urinary Tract) To Enhance Urine Flow. |
| 53460-CPT | Moderate | Urethromeatoplasty W/ Partial Xcision Of Distal Urethral Sgment, Urethromeatoplasty With Partial Excision Of Distal Urethral Segment ( |
| 53500-CPT | Moderate | Urethrlys Transvag W Scope, Urethrolysis Transvaginal Secondary Open Including Cystourethroscopy Eg Postsurgical Obstruction Scarring |
| 53600-CPT | Low | Dilation Of Urethral Strictur, Dilation Of Urethral Stricture By Passage Of Sound Orurethral Dilator Male Initial Dilation Of Urethral Stricture By Passage Of Sound Or |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53460. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53460 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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