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See a sample rate comparisonCPT 54110 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.
Treatment For Plaque In Penis, Surgery To Remove The Fibrous Tissue That Forms Within The Penis In Peyronies Disease. The Procedure May Involve Skin Grafts To Reconstruct An Area.
| 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 59 - Distinct Procedural Service XE - Separate encounter |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54110 |
| Medicaid Fee Schedule | View Medicaid rates for 54110 |
National average reimbursement for CPT 54110 by major payers:
$761.73
$834.11
$862.61
$1,022.00
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CPT 54110
5 of 25 sample ratesHigher to lower in this preview
Roswell Surgery Center LLC, Roswell Surgery Center
Roswell Surgery Center LLC
$5,433.00Published rateCrown Valley Surgery Center
$3,400.00Published rateNorth Pacific Dermatology Ps
$2,629.00Published rateJackson Surgery Center, LLC
Jackson Surgery Center LLC
$2,000.00Published rateCascade Eye & Skin Centers PC, Cascade Laser & Surgery Center
Cascade Eye And Skin Centers, P.C.
$945.00Published rate
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See a sample payer proposalCPT 54110 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54110 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 54110 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 |
|---|---|---|
| 54100-CPT | Moderate | Biopsy Of Penis |
| 54105-CPT | Moderate | Biopsy Penis Deep Structures |
| 54110-CPT | Moderate | Treatment For Plaque In Penis, Surgery To Remove The Fibrous Tissue That Forms Within The Penis In Peyronies Disease. The Procedure May Involve Skin Grafts To Reconstruct An Area. |
| 54111-CPT | High | Treatment For Plaque In Penis, Surgery To Remove The Fibrous Tissue That Forms Within The Penis In Peyronies Disease. The Procedure May Involve Skin Grafts To Reconstruct An Area. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54110 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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