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See a sample rate comparisonCPT 54065 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.
Destruction Penis Lesion S, Destruction Of Lesion S Penis Eg Condyloma Papilloma Molluscum Contagiosum Herpetic Vesicle Extensive Eg Laser Surgery Electrosurgery Cryosurgery Chemosurgery
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54065 |
| Medicaid Fee Schedule | View Medicaid rates for 54065 |
National average reimbursement for CPT 54065 by major payers:
$272.25
$286.12
$308.12
$290.83
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CPT 54065
5 of 25 sample ratesHigher to lower in this preview
Willmar Medical Services, LLP
Carris Health LLC
$2,967.00Published rateDenver Mid-Town Surgery Center Ltd
Denver Midtown Surgery Center Ltd
$1,558.00Published ratePuget Sound Gastroenterology, PLLC, Edmonds Endoscopy Center
Puget Sound Gastroenterology, P.S.
$936.00Published rateCenter For Assisted Reproduction Laboratory And Surgery Center, Inc.
Center For Assisted Reproduction Laboratory And Surgery Center Inc
$645.00Published rateChildrens Surgery Center Of Malvern, LLC
Childrens Surgery Center Of Malvern LLC
$414.00Published rate
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See a sample payer proposalCPT 54065 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54065 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 54065 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 | 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 |
| 54055-CPT | Low | Remove Abnormal Penis Tissue, Removal Of Abnormal Tissue From The Surface Of The Penis. Methods Include Swabbing With A Chemical Freezing Laser Or Minor Surgery. |
| 54056-CPT | Low | Remove Abnormal Penis Tissue, Removal Of Abnormal Tissue From The Surface Of The Penis. Methods Include Swabbing With A Chemical Freezing Laser Or Minor Surgery. |
| 54065-CPT | Moderate | Destruction Penis Lesion S, Destruction Of Lesion S Penis Eg Condyloma Papilloma Molluscum Contagiosum Herpetic Vesicle Extensive Eg Laser Surgery Electrosurgery Cryosurgery Chemosurgery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54065 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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