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CPT 54112 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Excis Penile Plaque;W/Grft Ovr 5 Cm
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Male Genital System

Common Place of Service

24 - Ambulatory Surgical Center

22 - On Campus Outpatient Hospital

Common Modifiers

None

22 - Increased Procedural Services

GC - Service performed by resident under supervision

Complexity LevelHigh
CMS$910.23 Physician Fee Schedule

National average reimbursement for CPT 54112 by major payers:

bcbs

$1,167.11

uhc

$1,254.54

aetna

$1,295.24

cigna

$1,570.92

Preview provider-level rates for...
For billing codeCPT 54112
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 54112

United
54112$3864.001770731853 - SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER LENEXA364634843 - (KS) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$5354.001295344026 - WEST CHESTER SURGICAL SUITES, LLC845072006 - (OH) WEST CHESTER SURGICAL SUITES LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$8238.001851650428 - TEXAS HEALTH OUTPATIENT SURGERY CENTER ALLIANCE822296081TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$5433.001659748184 - SURGCENTER OF THE POTOMAC, LLC472311914 - (MD) SURGCENTER OF THE POTOMAC, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$4601.001427049352 - CENTER FOR AMBULATORY SURGERY, LLC, THE CENTER FOR AMBULATORY SURGERY223638149 - (NJ) THE CENTER FOR AMBULATORY SURGERY LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$6274.001356878052 - PAVILION SURGERY CENTER LLC814376492 - (CA) PAVILION SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$7121.001083656318 - SURGERY CENTER OF OVERLAND PARK LP201011611 - (KS) SURGERY CENTER OF OVERLAND PARK LPKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$2920.001528253523 - MESQUITE TX ENDOSCOPY ASC LLC, TEXAS GI ENDOSCOPY CENTER260290859 - (TX) THE MESQUITE TX ENDOSCOPY ASC, LLC D.B.ATXAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$1686.931336128339 - RAJESH PATEL350593390 - DEACONESS HOSPITAL INCINAnesthesiology Physician (207L00000X)
United
54112$3148.001962958223 - NORTHGLENN ENDOSCOPY CENTER LLC812984347 - (CO) NORTHGLENN ENDOSCOPY CENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$722.001093921298 - INDIANA SKIN CANCER AMBULATORY SURGICAL CENTER LLC260149227 - (IN) INDIANA SKIN CANCER AMBULATORY SURGICAL CENTER LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$1508.001801949631 - THIBODAUX SURGERY CENTER, LLC, BAYOU REGION SURGICAL CENTER320165642 - (LA) THIBODAUX SURGERY CENTER, LLC DBA BAYOU REGION SURGICAL CENTERLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$6506.001891450805 - NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC364920288 - (CO) NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$5354.001881905792 - SURGCENTER PINELLAS, LLC271372259 - (FL) SURGCENTER PINELLAS, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
54112$21412.001528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE720502505 - (LA) OCHSNER CLINIC FOUNDATIONLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 54112 vs. Other Surgical Procedures on the Male Genital System Codes

The CPT 54112 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 54112 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.

CodeComplexityDescription
54112-CPTHighExcis Penile Plaque;W/Grft Ovr 5 Cm
54115-CPTModerateRemoval Fb Penis (Implant)
54205-CPTModerateInjec Procd-Peyrnie;Surg.Expos-Plaq
54235-CPTLowInjection Into Corpora Cavernosa

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54112. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 54112 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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