CPT 54150 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Male Genital System |
| Common Place of Service | • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 54150 |
National average reimbursement for CPT 54150 by major payers:
$196.34
$217.00
$235.89
$257.22
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 54150 | ||||||
United | 54150 | $1600.00 | 1750567442 - IRELAND GROVE CENTER FOR SURGERY LLC. | 202687982 - (IL) IRELAND GROVE CENTER FOR SURGERY, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $1300.00 | 1003357377 - NEPHROLOGY PHYSICIANS LLC | 352082018 - (IN) NEPHROLOGY PHYSICIANS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $890.00 | 1609039056 - FARSHID PAYDAR MD PC, THE EYE CLINIC | 454779006 - (AZ) FARSHID PAYDAR MD PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $443.00 | 1285664466 - NEWPORT MULTI SPECIALTY SURGERY CENTER LLC | 710874859 - (CA) NEWPORT MULTI SPECIALTY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $950.00 | 1932657335 - VOLUSIA ORTHOPAEDIC TRAUMA CALL ASSOCIATES LLC, EAST COAST SURGERY CENTER | 300950557 - (FL) VOLUSIA ORTHOPAEDIC TRAUMA CALL ASSOCIATES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $515.00 | 1518155811 - THE ALTAMONTE SPRINGS FL ENDOSCOPY ASC LLC, PALM ENDOSCOPY CENTER | 260289067 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $700.00 | 1679605729 - METROPOLITAN SURGICAL ASSOCIATES INC. DBA METROPOLITAN MEDICAL ASSOC | 222306421 - (NJ) METROPOLITAN SURGICAL ASSOCIATES, INC. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $443.00 | 1437274495 - EYE SURGICAL CENTER OF SAN FRANCISCO LLC, EYE SURGERY CENTER OF SAN FRANCISCO | 203822864 - (CA) EYE SURGERY CENTER OF SAN FRANCISCO | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $2057.00 | 1417278011 - WILSHIRE SURGERY CENTER, LLC | 270616665 - (OR) WILSHIRE SURGERY CENTER | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $975.00 | 1336100189 - ST MICHAELS SURGERY CENTER INC. | 593748609 - (FL) ST MICHAELS SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $2849.00 | 1629703236 - NORTH CYPRESS SURGICENTER, LLC, NORTH CYPRESS SURGERY CENTER | 851383722 - (TX) NORTH CYPRESS SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $3746.00 | 1386609964 - SOUTH AUSTIN SURGERY CENTER LTD | 621775267 - (TX) SOUTH AUSTIN SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $8705.00 | 1386159853 - BELTWAY SURGERY CENTERS, LLC, EAGLE HIGHLANDS SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $889.00 | 1114907920 - MIAMI ASC LP, THE ENDOSCOPY CENTER | 621600424 - (FL) MIAMI ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $944.88 | 1750358453 - CENTER FOR DIGESTIVE HEALTH LTD | 391738062 - (WI) THE CENTER FOR DIGESTIVE HEALTH LTD | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 54150 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54150 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 54150 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 |
|---|---|---|
| 54150-CPT | Low | Circumcision, Using Clamp Or Other Device With Regional Dorsal Penile Or Ring Block |
| 54160-CPT | Moderate | Circumcision, Surgical Excision Other Than Clamp, Device, Or Dorsal Slit; Neonate (28 Days Of Age Or Less) |
| 54161-CPT | Moderate | Circumcision, Surgical Excision Other Than Clamp, Device, Or Dorsal Slit; Older Than 28 Days Of Age |
| 54162-CPT | Moderate | Lysis Or Excision Of Penile Post-Circumcision Adhesions |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54150. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54150 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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