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See a sample rate comparisonCPT 53854 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Trurl Dstrj Prst8 Tiss Rf Wv, Destruction Of Prostate Tissue Accessed Through Urethra Using Radiofrequency Generated Water Vapor Heat Therapy
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 53854 |
| Medicaid Fee Schedule | View Medicaid rates for 53854 |
National average reimbursement for CPT 53854 by major payers:
$1,946.39
$2,406.85
$2,503.51
$931.11
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CPT 53854
5 of 25 sample ratesHigher to lower in this preview
Hallandale Outpatient Surgical Center,Ltd
Hallandale Outpatient Surgical Centerltd
$22,586.00Published rateWest Chester Surgical Suites, LLC
West Chester Surgical Suites LLC
$2,353.00Published rateEye And Laser Surgery Centers Of New Jersey LLC
$1,625.00Published rateNorthwest Endoscopy Center, LLC
Northwest Endoscopy Center LLC
$1,207.00Published rateFayetteville Gastroenterology Endoscopy Center, LLC
Fayetteville Gastroenterology Endoscopy Center LLC
$475.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 53854 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53854 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 53854 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 |
|---|---|---|
| 53850-CPT | High | Transurethr Destruct Of Prostat Tissue; By Microwav Thermothera, Transurethral Destruction Of Prostate Tissue; By Microwave Thermothera |
| 53852-CPT | High | Transurethr Destruct Of Prostat Tissue; By Radiofrequ Thermo, Transurethral Destruction Of Prostate Tissue; By Radiofrequency Thermo |
| 53854-CPT | High | Trurl Dstrj Prst8 Tiss Rf Wv, Destruction Of Prostate Tissue Accessed Through Urethra Using Radiofrequency Generated Water Vapor Heat Therapy |
| 53855-CPT | Moderate | Insert Device To Pass Urine, Insertion Of A Temporary Device To Hold Open The Urinary Tract (Stent). This Helps Urine Flow Past An Enlarged Prostate Gland. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53854. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53854 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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