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CPT 53620 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.

Dil Urethra W Filiform Male Initial
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Urinary System

Common Place of Service

11 - Office

21 - Inpatient Hospital

23 - Emergency Room

Common Modifiers

None

59 - Distinct Procedural Service

AG - Primary physician

Complexity LevelLow
CMS$162.06 Physician Fee Schedule

National average reimbursement for CPT 53620 by major payers:

bcbs

$180.08

uhc

$182.88

aetna

$205.30

cigna

$257.29

Preview provider-level rates for...
For billing codeCPT 53620
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 53620

United
53620$434.001033213269 - CAPE COD EYE SURGERY & LASER CENTER, LLC, CAPE COD EYE SURGERY & LASER CENTER43398899 - (MA) CAPE COD EYE SURGERY & LASER CENTER, LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$575.001528377678 - NORTH TEXAS TEAM CARE SURGERY CENTER LLC271832985 - (TX) NORTH TEXAS TEAM CARE SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$730.001477516532 - SPECIALTY SURGICARE OF LAS VEGAS, LP260116160NVAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$185.001417987595 - ENDOSCOPY CENTER OF NORTH BALTIMORE412081861MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$2183.001356480099 - MEMORIALCARE SURGICAL CENTER AT SADDLEBACK LLC203678259CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$428.001831766955 - SOUTHEASTERN SURGICAL, LLC, RIVERFRONT SURGERY CENTER833821506 - (TN) SOUTHEASTERN SURGICAL LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$1963.001376591156 - CENTRAL PARK SURGERY CENTER, LLC, CENTRAL PARK SURGERY CENTER161705322 - (TX) CENTRAL PARK SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$590.001336103001 - PERKINS PLAZA AMBULATORY SURGERY CENTER LLC, LAKE SURGERY CENTER481264699 - (LA) LAKE ASCLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$1005.001144970807 - MEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC881391141TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$519.001023271459 - RIVERBEND AMBULATORY SURGERY CENTER LLC, DAY SURGERY AT RIVERBEND205575145 - (OR) RIVERBEND AMBULATORY SURGERY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$953.001396174454 - SURGERY CENTER OF SCOTTSDALE LLC731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$1158.001366416125 - TEXAS ORTHOPEDICS SURGERY CENTER, LLC, TEXAS ORTHOPEDICS SURGERY CENTER LIMITED PARTNERSHIP, LL743013713 - (TX) TEXAS ORTHOPEDICS SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$2307.001336180173 - BELTWAY SURGERY CENTERS LLC352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$396.001003889379 - THE WALDORF ENDOSCOPY ASC, LLC, WALDORF ENDOSCOPY CENTER621806186 - (MD) THE WALDORF ENDOSCOPY ASC LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
53620$675.001003332883 - DESERT VISTA SURGICAL CENTER LLC821195281 - (AZ) DESERT VISTA SURGICAL CENTER LLCAZAmbulatory 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 53620 vs. Other Surgical Procedures on the Urinary System Codes

The CPT 53620 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 53620 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
53515-CPTHighUrethrorrhaphy;Prostatomembranous
53520-CPTModerateClose Urethrostomy/Cutan Fist Male
53600-CPTLowDilat.Ureth.Stric-Sound,Dil,Mle;1st
53620-CPTLowDil Urethra W Filiform Male Initial

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53620. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 53620 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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