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See a sample rate comparisonCPT 54340 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.
Repair Urinary Complication, Surgery To Repair A Complication Of Hypospadias A Condition Present Since Birth Where The Urine Exits The Underside Of The Penis. The Repair May Involve A Skin Graft And Removal Of Scar Tissue Or Connective Tissue.
| 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 AG - Primary physician 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54340 |
| Medicaid Fee Schedule | View Medicaid rates for 54340 |
National average reimbursement for CPT 54340 by major payers:
$716.91
$762.96
$817.78
$935.80
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CPT 54340
5 of 25 sample ratesHigher to lower in this preview
Surgcenter Clearwater, LLC, Surgcenter Dunedin
Surgcenter Clearwater LLC
$4,339.00Published rateOmega Surgery Center LLC
$2,995.00Published rateThomas Eye Surgery Center Of Fayette
$1,935.00Published rateVp Surgery Center Of Auburn LLC
$1,320.00Published rateTopeka Surgery Center
$624.00Published rate
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See a sample payer proposalCPT 54340 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54340 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 54340 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 |
|---|---|---|
| 54336-CPT | High | One Stage Perineal Hypospadias, One Stage Perineal Hypospadias Repair Requiring Extensivedissection To Correct Chordee And Urethroplasty By Use Of Skin Graft Tube Andor Island Flap |
| 54340-CPT | Moderate | Repair Urinary Complication, Surgery To Repair A Complication Of Hypospadias A Condition Present Since Birth Where The Urine Exits The Underside Of The Penis. The Repair May Involve A Skin Graft And Removal Of Scar Tissue Or Connective Tissue. |
| 54344-CPT | High | Repair Urinary Complication, Surgery To Repair A Complication Of Hypospadias A Condition Present Since Birth Where The Urine Exits The Underside Of The Penis. The Repair May Involve A Skin Graft And Removal Of Scar Tissue Or Connective Tissue. |
| 54348-CPT | High | Repair Urinary Complication, Surgery To Repair A Complication Of Hypospadias A Condition Present Since Birth Where The Urine Exits The Underside Of The Penis. The Repair May Involve A Skin Graft And Removal Of Scar Tissue Or Connective Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54340. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54340 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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