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See a sample rate comparisonCPT 54125 Fee Schedule
Last Verified: October 2026
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.
Remove All Or Part Of Penis, Surgical Removal Of All Or A Part Of The Penis. The Procedure May Include Removal Of Nearby Lymph Nodes.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None KX - Requirements specified in the medical policy have been met 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 54125 |
| Medicaid Fee Schedule | View Medicaid rates for 54125 |
National average reimbursement for CPT 54125 by major payers:
$1,050.19
$1,089.53
$1,176.40
$1,340.80
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CPT 54125
5 of 25 sample ratesHigher to lower in this preview
Pinnacle Surgery Center, Inc
Pinnacle Surgery Center Inc
$5,000.00Published rateCoastal Surgical Specialists, Inc.
Coastal Surgical Institute
$1,413.00Published rateChildrens Surgery Center LLC, Adventhealth Surgery Center Maitland
Childrens Surgery Center LLC
$840.00Published rateCenter For Assisted Reproduction Laboratory And Surgery Center, Inc.
Center For Assisted Reproduction Laboratory And Surgery Center Inc
$645.00Published rateEye Care Surgery Center Of Memphis, LLC
$336.00Published rate
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See a sample payer proposalCPT 54125 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54125 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 54125 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 |
|---|---|---|
| 54120-CPT | Moderate | Remove All Or Part Of Penis, Surgical Removal Of All Or A Part Of The Penis. The Procedure May Include Removal Of Nearby Lymph Nodes. |
| 54125-CPT | High | Remove All Or Part Of Penis, Surgical Removal Of All Or A Part Of The Penis. The Procedure May Include Removal Of Nearby Lymph Nodes. |
| 54130-CPT | High | Remove All Or Part Of Penis, Surgical Removal Of All Or A Part Of The Penis. The Procedure May Include Removal Of Nearby Lymph Nodes. |
| 54135-CPT | High | Remove Penis Nodes, Amputation Of Penis Radical In Continuity With Bilateral Pelvic Lymphadenectomy Including External Iliac Hypogastric And Obturator Nodes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54125 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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