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See a sample rate comparisonCPT 53605 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.
Dilation Of Urethral Stricture, Dilation Of Urethral Stricture Or Vesical Neck By Passage Ofsound Or Urethral Dilator Male Generalor Conduction (Spinal) Anesthesia
| 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 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 53605 |
| Medicaid Fee Schedule | View Medicaid rates for 53605 |
National average reimbursement for CPT 53605 by major payers:
$88.24
$87.79
$90.01
$105.77
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CPT 53605
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Edgewood Place, LLC, Lawrence County Surgery Center Of Edgewood Surgical Hospital
Surgery Center At Edgewood Place, LLC Dba Edgewood Surgical Hospital
$3,405.88Published rateSummit Ambulatory Surgical Center, LLC
$1,179.00Published rateNorthern Illinois Surgery Center Limited Patrnership, The Center For Surgery
Northern Illinois Surgery Center Lp
$867.00Published rateCoronado Surgery Center LLC
$675.00Published rateCenter For Advanced Eye Surgery, Ltd
Center For Advanced Eye Surgery Ltd
$422.00Published rate
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See a sample payer proposalCPT 53605 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53605 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 53605 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 |
|---|---|---|
| 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 |
| 53601-CPT | Low | Dilation Of Urethral Strictur, Dilation Of Urethral Stricture By Passage Of Sound Orurethral Dilator Male Subsequent Dilation Of Urethral Stricture By Passage Of Sound Or |
| 53605-CPT | Low | Dilation Of Urethral Stricture, Dilation Of Urethral Stricture Or Vesical Neck By Passage Ofsound Or Urethral Dilator Male Generalor Conduction (Spinal) Anesthesia |
| 53620-CPT | Low | Dilation Of Urethral Strictur, Dilation Of Urethral Stricture By Passage Of Filiform Andfollower Male Initial Dilation Of Urethral Stricture By Passage Of Filiform And |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53605 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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