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See a sample rate comparisonCPT 54250 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 Sleep Study, Study Of The Penis During Normal Sleep Patterns. The Purpose Is To Measure Any Erections That May Occur During Rem Sleep Periods.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None 50 - Bilateral Procedure 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 54250 |
| Medicaid Fee Schedule | View Medicaid rates for 54250 |
National average reimbursement for CPT 54250 by major payers:
$151.87
$164.85
$167.14
$196.74
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CPT 54250
5 of 25 sample ratesHigher to lower in this preview
Ku Medwest Ambulatory Surgery Center, LLC
Ku Medwest Ambulatory Surgery Center LLC
$2,321.00Published rateChristus Ambulatory Surgery Center At Olympia Hills LLC, Christus Surgery Center Olympia Hills
Christus Ambulatory Surgery Center At Olympia Hills LLC
$452.00Published rateSt. Mina Interventional Pain Center, Inc, Mina Pain Center
St Mina Interventional Pain Center Inc
$200.00Published rateHamilton Eye Institute Surgery Center, L.P.
Hamilton Eye Institute Surgery Center Lp
$111.00Published rateKathleen Quatro
Deaconess Hospital Inc
$9.39Published rate
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See a sample payer proposalCPT 54250 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54250 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 54250 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. |
| 54408-CPT | Moderate | Rpair Of Compone(S) Of A Multi-Compone Inflate Penile Prosthe, Repair Of Component(S) Of A Multi-Component Inflatable Penile Prosthe |
| 54410-CPT | High | Remove Replace Penis Prosth, Removal And Replacement Of All Component S Of A Multi Component Inflatable Penile Prosthesis At The Same Operative Session |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54250 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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