CPT 54336 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • 22 - Increased Procedural Services • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 54336 |
National average reimbursement for CPT 54336 by major payers:
$1,430.67
$1,601.59
$1,654.44
$1,999.56
| 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 54336 | ||||||
United | 54336 | $5863.00 | 1578558763 - HUNT MEMORIAL HOSPITAL DISTRICT, HUNT REGIONAL HEALTHCARE | 751277293 - (TX) HUNT MEMORIAL HOSPITAL DISTRICT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1980.00 | 1407023161 - SOUTHWEST MINNESOTA SURGICAL CENTER, INC. | 261451498 - (MN) SOUTHWEST MINNESOTA SURGICAL CENTER INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $6285.00 | 1609052679 - BELTWAY SURGERY CENTERS, LLC, BELTWAY SURGERY CENTER SPRINGMILL | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1065.75 | 1255070116 - MERCY SOUTH ASC LLC, MERCY OUTPATIENT SURGERY CENTER - WEST BEND | 882512783 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $3870.00 | 1841920683 - ENDOSCOPY CENTER OF BEVERLY HILLS LLC | 872038458 - ENDOSCOPY CENTER OF BEVERLY HILLS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1424.00 | 1730152869 - BEL AIR ENDOSCOPY ASC LLC, HARFORD ENDOSCOPY CENTER | 621827593 - (MD) BEL AIR ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $965.00 | 1295851137 - PHYSICIANS SURGERY CENTER LLC | 200435814 - (AR) PHYSICIANS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1320.00 | 1164976478 - FRANCISCAN MEDICAL GROUP, THE DOCTORS CLINIC AMBULATORY SURGICAL CENTER, A PART OF THE FRANCISCA | 911939739 - FRANCISCAN MEDICAL GROUP | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1305.00 | 1255404398 - WARMINSTER AMBULATORY SURGICAL, BUXMONT AMBULATORY SURGICAL CENTER | 232779763 - (PA) WARMINSTER AMBULATORY SURGICAL | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1320.00 | 1427144336 - PORTLAND CLINIC, THE PORTLAND CLINIC SURGICAL CENTER | 930400952 - (OR) THE PORTLAND CLINIC LLP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $2220.00 | 1801443320 - ST. LUKE'S SURGERY CENTER OF CHESTERFIELD, LLC | 384106846 - (MO) ST LUKES SURGERY CENTER OF CHESTERFIELD LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1300.00 | 1225497019 - LANGLEY HOLDINGS, LLC | 473550370 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1485.00 | 1750529814 - WEST BRIDGEWATER MA ENDOSCOPY ASC LLC, COMMONWEALTH ENDOSCOPY CENTER | 261765306 - (MA) WEST BRIDGEWATER MA ENDOSCOPY ASC LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $3188.00 | 1174802045 - LEONARDTOWN SURGERY CENTER LLC | 452019132 - (MD) LEONARDTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54336 | $1100.00 | 1972711471 - NOVI SURGERY CENTER LLC, NOVI SURGERY CENTER | 201600650 - (MI) NOVI SURGERY CENTER, LLC | MI | 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 54336 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54336 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 54336 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 |
|---|---|---|
| 54332-CPT | High | One Stage Proximal Penile Or Penoscrotal Hypospadias Repair Requiring Extensive Dissection To Correct Chordee And Urethroplasty By Use Of Skin Graft Tube And/Or Island Flap |
| 54336-CPT | High | One Stage Perineal Hypospadias Repair Requiring Extensive Dissection To Correct Chordee And Urethroplasty By Use Of Skin Graft Tube And/Or Island Flap |
| 54340-CPT | Moderate | Repair Of Hypospadias Complication(S) (Ie Fistula Stricture Diverticula); By Closure Incision Or Excision Simple (Desc Rvsd 1/1/22) |
| 54344-CPT | High | Repair Of Hypospadias Complications (Ie Fistula Stricture Diverticula); Requiring Mobilization Ofskin Flaps And Urethroplasty With Flap Or Patch Graft (Desc Rvsd 1/1/22) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54336. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54336 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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