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See a sample rate comparisonCPT 54304 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.
Plastic Operation On Penis For, Plastic Operation On Penis For Correction Of Chordee Or For First Stage Hypospadias Repair With Or Without Transplantation Of Prepuce Andor Skin Flaps
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None SG - Scene to Hospital ESRD facility 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54304 |
| Medicaid Fee Schedule | View Medicaid rates for 54304 |
National average reimbursement for CPT 54304 by major payers:
$929.69
$1,008.21
$1,082.14
$1,229.24
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CPT 54304
5 of 25 sample ratesHigher to lower in this preview
Coral Ridge Outpatient Center LLC, Coral Ridge Outpatient Center
Coral Ridge Outpatient Center, LLC
$5,433.00Published ratePlastic Head And Neck Surgery Institute
$3,452.00Published rateOcotillo Surgery Center LLC
$2,000.00Published rateSan Francisco Endoscopy Center LLC
$1,320.00Published rateDigestive Health & Endoscopy Center LLC
$586.00Published rate
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See a sample payer proposalCPT 54304 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54304 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 54304 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 |
|---|---|---|
| 54300-CPT | Moderate | Plastic Operation Of Penis For, Plastic Operation Of Penis For Straightening Of Chordee (Eghypospadias) With Or Without Mobilization Of Urethra |
| 54304-CPT | Moderate | Plastic Operation On Penis For, Plastic Operation On Penis For Correction Of Chordee Or For First Stage Hypospadias Repair With Or Without Transplantation Of Prepuce Andor Skin Flaps |
| 54322-CPT | Moderate | One Stage Distal Hypospadias R, One Stage Distal Hypospadias Repair (With Or Without Chordeeor Circumcision) With Simple Meatal Advancement (Eg Magpi V-Flap) |
| 54324-CPT | High | One Stage Distal Hypospadias R, One Stage Distal Hypospadias Repair (With Or Without Chordeeor Circumcision) With Urethroplasty By Local Skin Flaps (Eg Flip-Flap Prepucial Flap) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54304 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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