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See a sample rate comparisonCPT 54220 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.
Release Of Prolonged Erection, One Of Various Surgeries Designed To Correct Uncontrolled Or Abnormal Blood Flow To The Penis Thus Releasing A Prolonged Erection (Priapism).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 23 - Emergency Room 11 - Office |
| Common Modifiers | None AG - Primary physician GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54220 |
| Medicaid Fee Schedule | View Medicaid rates for 54220 |
National average reimbursement for CPT 54220 by major payers:
$261.29
$281.64
$308.11
$341.21
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CPT 54220
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Main Street, LLC
$1,831.00Published rateNorthwest Georgia Orthopaedic Surgery Center, LLC
Northwest Georgia Orthopaedic Surgery Center LLC
$531.00Published rateEar Nose And Throat Surgery Center LLC
$200.00Published rateGulf Coast Outpatient Surgery Center LLC, Gulf Coast Outpatient Surgery Center
Gulf Coast Outpatient Surgery Center, LLC
$134.00Published rateCollege Heights Endoscopy Center LLC
$54.00Published rate
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See a sample payer proposalCPT 54220 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54220 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 54220 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 |
|---|---|---|
| 54205-CPT | Moderate | Treatment For Plaque In Penis, Injection Of Medication In Or Near The Fibrous Tissue That Forms Inside The Penis With Peyronies Disease. The Medicine Eases The Abnormal Muscle Contraction. |
| 54220-CPT | Moderate | Release Of Prolonged Erection, One Of Various Surgeries Designed To Correct Uncontrolled Or Abnormal Blood Flow To The Penis Thus Releasing A Prolonged Erection (Priapism). |
| 54230-CPT | Low | Injec.Proced-Corpora Cavernosogrphy |
| 54231-CPT | Low | Erectile Study With Treatment, Study Of Blood Pressure Variance In The Penis Including Injection Of Medication To Treat Erectile Dysfunction. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54220 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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