Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 54115 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.
Remval Foreign Body From Deep Penile Tissue (Eg Plstic Implnt), Removal Foreign Body From Deep Penile Tissue (Eg Plastic Implant)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54115 |
| Medicaid Fee Schedule | View Medicaid rates for 54115 |
National average reimbursement for CPT 54115 by major payers:
$566.89
$606.03
$628.96
$702.86
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 54115.
CPT 54115
5 of 25 sample ratesHigher to lower in this preview
Hospital For Special Surgery West Side Ambulatory Surgery Center, LLC, Hss West Side Asc, LLC
$6,713.00Published rateOil Center Surgical Plaza
$3,048.00Published rateChandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center
$2,353.00Published rateManatee Surgical Center, LLC
$990.00Published rateGreat Lakes Ambulatory Surgery Center
$663.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 54115 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54115 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 54115 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 |
|---|---|---|
| 54112-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. |
| 54115-CPT | Moderate | Remval Foreign Body From Deep Penile Tissue (Eg Plstic Implnt), Removal Foreign Body From Deep Penile Tissue (Eg Plastic Implant) |
| 54406-CPT | Moderate | Remove Muti Comp Penis Pros, Removal Of All Components Of A Multi Component Inflatable Penile Prosthesis Without Replacement Of Prosthesis |
| 54408-CPT | Moderate | Rpair Of Compone(S) Of A Multi-Compone Inflate Penile Prosthe, Repair Of Component(S) Of A Multi-Component Inflatable Penile Prosthe |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54115. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54115 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 54115) and we'll show you how you compare in 15 minutes or less.