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See a sample rate comparisonCPT 54240 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.
Erectile Study, Study Of The Variations In Blood Flow And Volume Of The Penis To Determine The Physiological Potential To Attain And Hold An Erection. An Instrument Called A Plethysmograph Is Used.
| 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 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 54240 |
| Medicaid Fee Schedule | View Medicaid rates for 54240 |
National average reimbursement for CPT 54240 by major payers:
$123.63
$135.61
$141.39
$168.14
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CPT 54240
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers LLC, Indiana Hand To Shoulder Beltway Surgery Center
$4,613.00Published rateCreekwood Surgery Center, Lp
Creekwood Surgery Center Lp
$633.00Published rateColiseum Same Day Surgery Center Lp
$285.00Published rateNorth Idaho Pain Center LLC
$158.00Published rateAhmed Aziz
Deaconess Hospital Inc
$63.36Published rate
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See a sample payer proposalCPT 54240 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54240 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 54240 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 |
|---|---|---|
| 54240-CPT | Low | Erectile Study, Study Of The Variations In Blood Flow And Volume Of The Penis To Determine The Physiological Potential To Attain And Hold An Erection. An Instrument Called A Plethysmograph Is Used. |
| 54250-CPT | Low | Erectile Sleep Study, Study Of The Penis During Normal Sleep Patterns. The Purpose Is To Measure Any Erections That May Occur During Rem Sleep Periods. |
| 54401-CPT | Moderate | Penis Implant Surgery, Surgery To Implant A Prosthesis Into The Penis. A Prosthesis May Be Semi-Rigid Or Inflatable. The Inflatable Prosthesis May Include A Pump And Reservoir As Well. |
| 54405-CPT | High | Penis Implant Surgery, Surgery To Implant A Prosthesis Into The Penis. A Prosthesis May Be Semi-Rigid Or Inflatable. The Inflatable Prosthesis May Include A Pump And Reservoir As Well. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54240 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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