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See a sample rate comparisonCPT 54318 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.
Urethroplasty For Third Stage, Urethroplasty For Third Stage Hypospadias Repair To Release Penis From Scrotum (Eg Third Stage Cecil Repair)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None AG - Primary physician 82 - Assistant surgeon - no qualified resident |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54318 |
| Medicaid Fee Schedule | View Medicaid rates for 54318 |
National average reimbursement for CPT 54318 by major payers:
$896.12
$953.26
$984.81
$1,167.28
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CPT 54318
5 of 25 sample ratesHigher to lower in this preview
Baptist Surgery Center Lp, Baptist Ambulatory Surgery Center
Baptist Surgery Center Lp
$5,772.00Published rateBsc Chandler LLC
$2,855.00Published rateSouthern Oklahoma Surgical Center Inc
Southern Oklahoma Surgical Center, Inc.
$1,688.00Published ratePlaza Ambulatory Surgery Center LLC
$1,320.00Published rateAmbulatory Surgery Center LLC, Ambulatory Surgery Center
Ambulatory Surgery Center LLC
$847.00Published rate
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See a sample payer proposalCPT 54318 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54318 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 54318 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 |
|---|---|---|
| 54318-CPT | Moderate | Urethroplasty For Third Stage, Urethroplasty For Third Stage Hypospadias Repair To Release Penis From Scrotum (Eg Third Stage Cecil Repair) |
| 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) |
| 54326-CPT | High | One Stage Distal Hypospadias R, One Stage Distal Hypospadias Repair (With Or Without Chordeeor Circumcision) With Urethroplasty By Local Skin Flaps And Mobilization Of Urethra |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54318. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54318 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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