CPT 54057 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 Male Genital System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| CMS | $135.86 Physician Fee Schedule |
National average reimbursement for CPT 54057 by major payers:
$176.69
$181.61
$192.14
$233.24
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 54057 | ||||||
United | 54057 | $406.00 | 1689311938 - HURON GASTRO ENDOSCOPY CENTER LLC, HURON GASTRO CENTER FOR DIGESTIVE CARE | 853580801 - (MI) HURON GASTRO ENDOSCOPY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $1126.00 | 1700838471 - SANTA CRUZ SURGERY CENTER | 770194916 - (CA) SANTA CRUZ SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $1123.00 | 1174802045 - LEONARDTOWN SURGERY CENTER LLC | 452019132 - (MD) LEONARDTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $503.00 | 1023015989 - TUCSON GASTROENTEROLOGY INSTITUTE, LLC | 860966257 - (AZ) TUCSON GASTROENTEROLOGY INSTITUTE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $734.00 | 1053353359 - VISION SURGERY & LASER CENTER, LLC | 931308251 - (OR) VISION SURGERY LASER CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $1276.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $1300.00 | 1265431670 - AUBURN SURGERY CENTER INC. | 431937843 - (MO) AUBURN SURGERY CENTER INC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $650.00 | 1083606867 - NOVAMED SURGERY CENTER OF TYLER, LP, CATARACT CENTER OF EAST TEXAS | 680510003 - (TX) NOVAMED SURGERY CENTER OF TYLER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $1276.00 | 1639134505 - PUEBLO AMBULATORY SURGERY CENTER LLC | 621488737 - (CO) PUEBLO AMBULATORY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $658.00 | 1629135843 - NAEEM M AKHTAR, MADERA AMBULATORY ENDOSCOPY CENTER | 770194609 - (CA) NAEEM M. AKHTAR, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $592.00 | 1225039761 - ENDOSCOPY CENTER OF ST THOMAS LLC, ST THOMAS MEDICAL GROUP ENDOSCOPY CENTER | 621512411 - (TN) ENDOSCOPY CENTER OF ST THOMAS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $244.80 | 1740230267 - DAVID RYON | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 54057 | $1258.00 | 1053764779 - SURGCENTER OF ST. LUCIE, LLC | 475425011 - (FL) SURGCENTER OF ST. LUCIE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $1558.00 | 1336790237 - AURORA ENDOSCOPY SURGICENTER, LLC | 825396997 - (CO) AURORA ENDOSCOPY SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54057 | $1400.00 | 1063058303 - CHESAPEAKE REGIONAL SURGERY CENTER AT VIRGINIA BEACH, LLC | 843621271 - (VA) CHESAPEAKE REGIONAL SURGERY CENTER AT VIRGINIA BEACH LLC | VA | 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 54057 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54057 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 54057 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 |
|---|---|---|
| 54050-CPT | Low | Destruc Lesion,Penis,Smple;Chemical |
| 54055-CPT | Low | Destruction Of Lesion(S), Penis (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Electrodesiccation |
| 54056-CPT | Low | Destruction Of Lesion(S), Penis (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Cryosurgery |
| 54057-CPT | Low | Destruction Of Lesion(S), Penis (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Laser Surgery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54057. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54057 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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