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See a sample rate comparisonCPT 54162 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.
Repair Following Circumcision, Surgical Repair Related To A Complication Of A Circumcision. The Initial Procedure May Have Left Foreskin In Place Or Scar Tissue (Adhesion) May Have Formed. Either Can Restrict Normal Movement.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54162 |
| Medicaid Fee Schedule | View Medicaid rates for 54162 |
National average reimbursement for CPT 54162 by major payers:
$333.05
$347.41
$378.68
$337.02
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CPT 54162
5 of 25 sample ratesHigher to lower in this preview
Saint Luke'S Surgicenter
Saint Lukes Surgicenter
$5,177.00Published rateScottsdale Endoscopy Asc LLC
$2,388.00Published rateMedina-Summit Ambulatory Surgery Center, The Medina Surgery Center
Summa Health, Pension Administation Committee
$1,882.00Published rateNaadi Manteca Asc
$1,274.00Published rateMaple Springs Podiatric Surgical Center, Inc
Maple Springs Podiatric Surgical Center Inc
$525.00Published rate
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See a sample payer proposalCPT 54162 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54162 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 54162 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 | Circumcisi Using Clamp Or Other Devic W/ Rgional Dorsal Penile, Circumcision Using Clamp Or Other Device With Regional Dorsal Penile |
| 54161-CPT | Moderate | Circumcisi Surg Xcision Other Than Clamp Devic Or Dorsal Sl, Circumcision Surgical Excision Other Than Clamp Device Or Dorsal Sl |
| 54162-CPT | Moderate | Repair Following Circumcision, Surgical Repair Related To A Complication Of A Circumcision. The Initial Procedure May Have Left Foreskin In Place Or Scar Tissue (Adhesion) May Have Formed. Either Can Restrict Normal Movement. |
| 54300-CPT | Moderate | Plastic Operation Of Penis For, Plastic Operation Of Penis For Straightening Of Chordee (Eghypospadias) With Or Without Mobilization Of Urethra |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54162. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54162 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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