CPT 54322 Fee Schedule
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.
| 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 • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54322 |
National average reimbursement for CPT 54322 by major payers:
$994.75
$1,048.37
$1,141.66
$1,309.32
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 54322 | ||||||
United | 54322 | $1320.00 | 1720359151 - ST JOHN SURGERY CENTER INC | 454271780 - (CA) ST JOHN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $3570.00 | 1659517019 - SURGERY CENTER OF PEMBROKE PINES, LLC | 263364068 - (FL) SURGERY CENTER OF PEMBROKE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $2502.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $2100.00 | 1568503845 - MINNESOTA VASCULAR SURGERY CENTER | 204879005 - (MN) MINNESOTA VASCULAR SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $2946.00 | 1043236664 - ST. MARY'S AMBULATORY SURGERY CENTER, LLC | 593812095 - (VA) ST MARYS AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $820.00 | 1750920591 - HAYDEN SURGICAL CENTER LLC | 844085494 - (AZ) HAYDEN SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $597.00 | 1396192241 - ANDERSON ENDOSCOPY CENTER LLC | 811947476 - (OH) ANDERSON ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $3879.00 | 1164732426 - NORWALK SURGERY CENTER, LLC | 272394942 - (CT) NORWALK SURGERY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $2300.00 | 1063422962 - SAN ANTONIO AMBULATORY SURGICAL CENTER, LLC | 330857893 - (CA) SAN ANTONIO AMBULATORY SURGICAL CTR TER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $1130.00 | 1821397654 - RENUE SURGERY CENTER OF WAYCROSS, LLC | 273847480 - (GA) RENUE SURGERY CENTER OF WAYCROSS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $4600.00 | 1578530226 - PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP, BAYLOR SCOTT & WHITE SURGICARE FORT WORTH | 208303422 - (TX) PHYSICIANS SURGICAL CENTER OF FT WORTH LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $1209.00 | 1558416255 - VIRGIL V. WILLARD, II MD PA, CENTER FOR IMAGE DISCOVERY PA | 300399108 - (NC) VIRGIL V WILLARD II MD PA | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $3500.00 | 1588785208 - AMBER MEADOWS SURGERY CENTER LLC | 208756114 - (MD) AMBER MEADOWS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $2274.00 | 1356616064 - CORONA SURGICAL LLC, CORONA SUMMIT SURGICAL CENTER | 900722404 - (CA) CORONA SURGICAL LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54322 | $4994.00 | 1336148360 - BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER, LLC, BOULDER SURGERY CENTER | 201391702 - (CO) BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 54322 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54322 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 54322 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 |
|---|---|---|
| 54322-CPT | Moderate | One Stage Distal Hypospadias Repair (With Or Without Chordee Or Circumcision); With Simple Meatal Advancement (Eg Magpi V- Flap) |
| 54324-CPT | High | One Stage Distal Hypospadias Repair (With Or Without Chordee Or Circumcision); With Urethroplasty By Local Skin Flaps (Eg Flip- Flap Prepucial Flap) |
| 54326-CPT | High | One Stage Distal Hypospadias Repair (With Or Without Chordee Or Circumcision); With Urethroplasty By Local Skin Flaps And Mobilization Of Urethra |
| 54328-CPT | High | One Stage Distal Hypospadias Repair (With Or Without Chordee Or Circumcision); With Extensive Dissection To Correct Chordee And Urethroplasty With Local Skin Flaps Skin Graft Patch And/Or Island Flap |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54322. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54322 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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