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CPT 53505 Fee Schedule

Last Verified: November 2025

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.

Urethrorr,Suture Ureth.Wound;Penile
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Urinary System

Common Place of Service

22 - On Campus Outpatient Hospital

21 - Inpatient Hospital

Common Modifiers

None

51 - Multiple procedures

78 - Return to OR - related procedure

Complexity LevelModerate
CMS$475.49 Physician Fee Schedule

National average reimbursement for CPT 53505 by major payers:

bcbs

$636.05

uhc

$653.03

aetna

$676.98

cigna

$816.20

Preview provider-level rates for...
For billing codeCPT 53505
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 53505

United
53505$2000.001982931465 - GARDEN GROVE SURGICAL CENTER INC271203227 - (CA) GARDEN GROVE SURGICAL CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$1100.001376641670 - AMBULATORY SURGERY CENTER OF GREATER NEW YORK, LLC133418924 - (NY) AMBULATORY SURGERY CENTER OF GREATER NEW YORK, LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$2016.001063437994 - TRI-CITIES ENDOSCOPY CENTER PC, THE CENTER FOR DIGESTIVE WELLNESS621867929 - (TN) TRICITIES ENDOSCOPY CENTER PCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$2307.001083873277 - VENTURE AMBULATORY SURGERY CENTER LLC743257508FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$753.001447212337 - PUGET SOUND GASTROENTEROLOGY, PLLC, EVERGREEN ENDOSCOPY CENTER911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$4140.001548238140 - DENTON SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - DENTON752708579 - (TX) DENTON SURGICARE PARTNERS LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$1726.001619244175 - BARRINGTON PAIN AND SPINE INSTITUTE, LLC, BARRINGTON AMBULATORY SURGERY CENTER273091392 - (IL) BARRINGTON PAIN AND SPINE INSTITUTE LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$744.001659903292 - RACINE DIGESTIVE HEALTH CENTER LLC844211105 - (WI) RACINE DIGESTIVE HEALTH CENTER LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$1410.001528000817 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER860423068 - SOUTHWESTERN EYE CENTER, LTD.AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$1665.001942261599 - SDOSC, LP, SAN DIEGO OUTPATIENT AMBULATORY SURGICAL CENTER30506487 - (CA) SDOSC, LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$2200.001609977610 - UOC SURGICAL SERVICES, LTD.251890694 - (PA) UOC SURGICAL SERVICES LTDPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$1222.001063445542 - TOTAL PAIN CARE LLC202484443 - (MS) TOTAL PAIN CARE, LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$3623.001376727214 - PROLIANCE SURGEONS INC PS, PROLIANCE SOUTHWEST SEATTLE SURGERY CENTER911606533 - (WA) PROLIANCE SURGEONS, INC., P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$1469.001043246077 - DUTCHESS AMBULATORY SURGICAL CENTER141803011 - (NY) DUTCHESS AMBULATORY SURGICAL CENTERNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
53505$4284.001013962521 - NEWPORT PLAZA SURGERY CENTER392060266CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 53505 vs. Other Surgical Procedures on the Urinary System Codes

The CPT 53505 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 53505 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.

CodeComplexityDescription
53425-CPTHighUrethroplasty Stg 2
53430-CPTHighUrethroplas,Reconst.Female Urethra
53502-CPTModerateUrethrorrhaphy Female
53505-CPTModerateUrethrorr,Suture Ureth.Wound;Penile

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 53505 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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