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See a sample rate comparisonCPT 54000 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.
Remove Foreskin Scar Tissue, Procedure To Cut The Foreskin Or Break Scar Tissue. This Enables The Foreskin To Be Moved. The Procedure May Be Done On A Newborn.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54000 |
| Medicaid Fee Schedule | View Medicaid rates for 54000 |
National average reimbursement for CPT 54000 by major payers:
$202.59
$207.84
$217.09
$190.97
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CPT 54000
5 of 25 sample ratesHigher to lower in this preview
Hss Asc Of Manhattan LLC, Hss Asc Of Manhattan
$7,482.00Published rateTorrance Ca Multispecialty Asc LLC, Surgery Center Of South Bay
Torrance Ca Multispecialty Asc LLC
$1,887.00Published rateNovamed Surgery Center Of Colorado Springs, LLC, Premier Surgery Center
$1,419.00Published rateWnc Eye Surgery Centers Inc
$990.00Published rateAlbert Umbach
Deaconess Hospital Inc
$124.83Published rate
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See a sample payer proposalCPT 54000 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54000 code is part of the Surgery services used for Surgical Procedures on the Male Genital 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 54000 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 |
|---|---|---|
| 54000-CPT | Moderate | Remove Foreskin Scar Tissue, Procedure To Cut The Foreskin Or Break Scar Tissue. This Enables The Foreskin To Be Moved. The Procedure May Be Done On A Newborn. |
| 54001-CPT | Moderate | Remove Foreskin Scar Tissue, Procedure To Cut The Foreskin Or Break Scar Tissue. This Enables The Foreskin To Be Moved. The Procedure May Be Done On A Newborn. |
| 54015-CPT | Moderate | Drainage Of Genital Injury, Procedure To Drain A Deep Abscess Or Hematoma (Pocket Of Infection Or Blood) From The Penis Scrotum Testicles Or Other Part Of The Genitals. |
| 54050-CPT | Low | Destruction Of Lesion(S) Pen, Destruction Of Lesion(S) Penis (Eg Condyloma Papilloma Molluscum Contagiosum Herpetic Vesicle) Simple Chemical Destruction Of Lesion(S) Penis (Eg Condyloma Papilloma |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54000 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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