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See a sample rate comparisonCPT 54230 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.
Injec.Proced-Corpora Cavernosogrphy
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 24 - Ambulatory Surgical Center 11 - Office |
| Common Modifiers | None 51 - Multiple procedures XU - Unusual Non-Overlapping Service AG - Primary physician 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 54230 |
| Medicaid Fee Schedule | View Medicaid rates for 54230 |
National average reimbursement for CPT 54230 by major payers:
$125.12
$130.87
$140.45
$166.29
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CPT 54230
5 of 25 sample ratesHigher to lower in this preview
Saint Luke'S Surgicenter
Saint Lukes Surgicenter
$2,347.00Published rateGrossmont Outpatient Surgical Center
Grossmont Outpatient Surgical Ce
$544.00Published rateFreeman Surgical Center LLC
Freeman Health System
$309.00Published rateSpecialty Surgery Center, LLC
Specialty Surgery Center LLC
$200.00Published rateSouthland Endoscopy Center, Southland Endoscopy Center
Southland Endoscopy Center
$88.00Published rate
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See a sample payer proposalCPT 54230 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54230 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 54230 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 |
|---|---|---|
| 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. |
| 54235-CPT | Low | Inject Of Corpora Cavernosa W/ Pharmacolog Agnt(S) (Eg Papave, Injection Of Corpora Cavernosa With Pharmacologic Agent(S) (Eg Papave |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54230. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54230 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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