CPT 53620 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| 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 Level | Low |
| Medicare Fee Schedule | View Medicare rates for 53620 |
National average reimbursement for CPT 53620 by major payers:
$180.08
$182.88
$205.30
$247.23
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 53620 | $410.00 | 1205874906 - CENTRAL GA HEAD &NECK SURGERY CENTER | 582379919 - (GA) CENTRAL GA HEAD NECK SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $645.00 | 1528060704 - CMMP SURGICAL CENTER LLC | 431709558 - (MO) CMMP SURGICAL CENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $887.00 | 1982149761 - THE POLYCLINIC, THE POLYCLINIC MOHS SURGERY | 910369070 - (WA) THE POLYCLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $2307.00 | 1336180173 - BELTWAY SURGERY CENTERS LLC | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $934.00 | 1255577045 - MAPLE LAWN SURGERY CENTER | 262739529 - (MD) MAPLE LAWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $953.00 | 1275292229 - SCOTTSDALE ENDOSCOPY ASC LLC | 873952617 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $490.00 | 1265405203 - BLOOMFIELD EYE SURGERY CENTER LLC, THE EYE SURGERY CENTER | 621827592 - (CT) BLOOMFIELD EYE SURGERY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $709.00 | 1912600826 - SURGICAL CENTER OF TVH | 882585662 - (ID) SURGICAL CENTER OF TVH | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $521.20 | 1841284742 - KLEINERT KUTZ SURGERY CENTER, LLC | 352095662 - (IN) KLEINERT KUTZ SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $107.73 | 1316454002 - KENNETH WATSON | 350593390 - DEACONESS HOSPITAL INC | GA | Certified Registered Nurse Anesthetist (367500000X) |
United | 53620 | $1462.00 | 1225275688 - MAIN STREET SPECIALTY SURGERY CENTER, LLC | 954813223 - (CA) MAIN STREET SPECIALTY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $532.00 | 1699748855 - MIDDLETOWN ENDOSCOPY ASC LLC, THE GI ENDOSCOPY CENTER | 621835826 - (OH) MIDDLETOWN ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $1963.00 | 1982716106 - THR/STT SOUTHLAKE ASC, LLC | 262429878 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 53620 | $234.49 | 1831159037 - AHMED AZIZ | 350593390 - DEACONESS HOSPITAL INC | MS | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 53620 | $218.00 | 1487765897 - BAY MICROSURGICAL UNIT | 570799855 - (SC) BAY MICROSURGICAL UNIT | SC | 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 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.
| Code | Complexity | Description |
|---|---|---|
| 53515-CPT | High | Urethrorrhaphy Suture Of Urethral Wound/Njury; Prostatomembrano, Urethrorrhaphy Suture Of Urethral Wound Or Injury; Prostatomembranous |
| 53520-CPT | Moderate | Closur Of Urethrostomy Or Urethrocutaneous Fistula Male, Closure Of Urethrostomy Or Urethrocutaneous Fistula Male (Separate Pr |
| 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 |
| 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 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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