CPT 54344 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 • AS - PA/NP/CNS assistant at surgery • AG - Primary physician • UB • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| CMS | $916.70 Physician Fee Schedule |
National average reimbursement for CPT 54344 by major payers:
$1,179.57
$1,285.07
$1,390.26
$1,597.95
| 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 54344 | ||||||
United | 54344 | $2010.00 | 1548837503 - HOUSTON IVF MANAGEMENT | 841602243 - (TX) HOUSTON IVF MANAGEMENT CO., LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1320.00 | 1093295545 - SURGERY CENTER 121 LLC | 831195079 - (TX) SURGERY CENTER 121 LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $4192.00 | 1992708929 - NOVAMED MANAGEMENT SERVICES LLC, ATLANTA EYE SURGERY CENTER | 364013255 - NOVAMED, INC. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1231.00 | 1033222989 - EMPIRE SURGERY CENTER | 770581233 - (CA) EMPIRE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1320.00 | 1346237328 - VICTORIA AMBULATORY SURGERY CENTER, LP, THE SURGERY CENTER | 352240144 - (TX) VICTORIA AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $5310.00 | 1588681373 - CONSTITUTION SURGERY CENTER EAST LLC | 61574704 - (CT) CONSTITUTION EYE SURGERY CENTER EAST, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $650.00 | 1932207669 - EYE SURGICAL CENTER OF MISSISSIPPI | 200669972 - (MS) EYE SURGICAL CENTER OF MISSISSIPPI | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1504.00 | 1700842358 - THE EYE SURGERY CENTER OF THE CAROLINAS LP | 205562797 - (NC) THE EYE SURGERY CENTER OF THE CAROLINAS LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $9098.00 | 1730212879 - TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $782.88 | 1649992116 - MADELEINE SERRANO | 350593390 - DEACONESS HOSPITAL INC | IN | Physician Assistant (363A00000X) |
United | 54344 | $1300.00 | 1508419474 - NORMAN REGIONAL HOSPITAL AUTHORITY, WEST NORMAN ENDOSCOPY | 736048282 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1320.00 | 1881678662 - SURGERY AFFILIATE OF EL PASO, LLC, FOUNDATION SURGERY AFFILIATE OF EL PASO, LLC | 742797719 - (TX) SURGERY AFFILIATE OF EL PASO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1224.00 | 1265488563 - SYRACUSE ASC, LLC, SPECIALTY SURGERY CENTER OF CNY | 161549512 - (NY) SPECIALTY SURGERY CENTER OF CNY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1317.00 | 1164597761 - OUTPATIENT EYE SURGERY CENTER | 721098835 - (LA) OUTPATIENT EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54344 | $1703.91 | 1881129286 - JOEL PHELPS | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
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 54344 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54344 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 54344 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 |
|---|---|---|
| 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) |
| 54348-CPT | High | Repair Of Hypospadias Complication(S) (Ie Fistula Stricture Diverticula); Requiring Extensive Dissection And Urethroplasty With Flap Patch Or Tubed Graft (Includes Urinary Diversion) (Desc Rvsd 1/1/22) |
| 54352-CPT | High | Revision Of Prior Hypospadias Repair Requiring Extensive Dissection And Excision Of Previously Constructed Structures Including Re-Release Of Chordee And Reconstruction Of Urethra And Penis Byuse Of Local Skin As Grafts And Island Flaps And Skin Brought In As Flaps Or Grafts (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 54344. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54344 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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