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See a sample rate comparisonCPT 54001 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 | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54001 |
| Medicaid Fee Schedule | View Medicaid rates for 54001 |
National average reimbursement for CPT 54001 by major payers:
$241.98
$258.30
$278.33
$242.05
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CPT 54001
5 of 25 sample ratesHigher to lower in this preview
Conroe Surgery Center 2, LLC
Conroe Surgery Center 2 LLC
$5,729.00Published rateHealthone Ridge View Endoscopy Center, LLC, South Denver Endoscopy Center
$2,564.00Published rateSound Surgeons PLLC, Northwest Weight Loss Surgery
Sound Surgeons, PLLC
$1,388.00Published rateOrange City Surgical LLC, Adventhealth Surgery Center Blue Springs
Orange City Surgical, LLC
$1,100.00Published rateLaplata Ambulatory Urological Center, L.L.C.
Laplata Ambulatory Urological Center LLC
$597.00Published rate
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See a sample payer proposalCPT 54001 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54001 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 54001 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 54001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54001 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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