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 |
| CMS | $143.94 Physician Fee Schedule |
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 | $2307.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | 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 | $2025.00 | 1336445873 - SAND LAKE SURGICENTER LLC, SAND LAKE SURGERY CENTER | 273787593 - (FL) SAND LAKE SURGICENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $425.00 | 1154526044 - KERRVILLE AMBULATORY SURGERY CENTER, LLC | 205121858 - (TX) KERRVILLE AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $1954.00 | 1912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $1564.00 | 1689986879 - DEER POINTE SURGICAL CENTER, LLC, POA SURGERY CENTER | 272384315 - (MD) DEER POINTE SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $1218.00 | 1871568329 - ROCKVILLE MD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY ASSOCIATES (GIEA) | 201732114 - (MD) ROCKVILLE MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $997.00 | 1295086049 - WOMENS CENTER FOR ADVANCED SURGERY INC | 454798001 - (GA) WOMENS CENTER FOR ADVANCED SURGERY INC | GA | 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 | $425.00 | 1154328243 - SALINAS ENDOSCOPY CENTER LLC | 770361270 - (CA) SALINAS ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $2621.00 | 1558487009 - MIDWEST DIGESTIVE HEALTH CENTER LLC | 431918703 - (MO) MIDWEST DIGESTIVE HEALTH CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $1300.00 | 1760860977 - MID MISSOURI SURGERY CENTER, LLC, SURGERY CENTER AT THE FORUM | 464006663 - (MO) MID-MISSOURI SURGERY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $425.00 | 1881015584 - ACE ENDOSCOPY AND SURGERY CENTER | 464212208 - (CA) ACE ENDOSCOPY & SURGERY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $1648.00 | 1720048242 - MARYLAND SURGERY CENTER FOR WOMEN LLC, MARYLAND SURGERY CENTER | 522215638 - (MD) MARYLAND SURGERY CENTER FOR WOMEN, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54150 | $1391.00 | 1306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC | 510571797 | VA | 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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