CPT 54348 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 |
| CMS | $980.10 Physician Fee Schedule |
National average reimbursement for CPT 54348 by major payers:
$1,228.35
$1,362.73
$1,412.68
$1,699.45
| 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 54348 | ||||||
United | 54348 | $2924.00 | 1710924899 - DMG SURGICAL CENTER LLC, SURGICAL CENTER OF DUPAGE MEDICAL GROUP | 371474161 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1320.00 | 1285696500 - SUTTER SURGERY CENTER LP | 680116391 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $3347.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1800.00 | 1497367262 - SNKS ENTERPRISES LLC, SOL VALLEY SURGERY CENTER | 364932587 - (AZ) SNKS ENTERPRISES LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $3623.00 | 1093086183 - CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC, CHANDLER ENDOSCOPY CENTER | 454307241 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $2750.00 | 1720227945 - WESTERN CONNECTICUT ORTHOPEDIC SURGICAL CENTER LLC, THE HAND CENTER OF WESTERN CONNECTICUT LLC | 61521999 - (CT) THE HAND CENTER OF WESTERN CONNECTICUT, L.L.C. | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $829.00 | 1649376757 - ADS HEALTHCARE LLC, ADS AMBULATORY SURGERY CENTER | 481207671 - (KS) ADS HEALTHCARE LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1500.00 | 1669621496 - CPM SURGERY CENTER 3, LLC | 263297851 - (GA) CPM SURGERY CENTER 3 LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1672.00 | 1073546875 - STRAND GASTROINTESTINAL ENDOSCOPY CENTER | 571082826 - (SC) STRAND GASTROINTESTINAL ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1301.00 | 1679656714 - LITTLETON DAY SURGERY CENTER LLC | 232731319 - (CO) LITTLETON DAY SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1320.00 | 1477949766 - DESCHUTES SURGERY CENTER, LLC, DESCHUTES SURGERY CENTER, LLC | 472920584 - (OR) DESCHUTES SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $3570.00 | 1275198673 - UROLOGY ASC- PHOENIX, LLC, UROLOGIC SURGERY CENTER OF ARIZONA | 320586987 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1500.00 | 1295258416 - PUMPKIN PATCH AMBULATORY SURGICAL CENTER, LLC, ORLANDO AVENUE SURGERY CENTER, LLC | 475078896 - (FL) PUMPKIN PATCH AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $3570.00 | 1972869881 - ADVANCED SURGERY CENTER OF BETHESDA, LLC | 454376136 - (MD) ASC BETHESDA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54348 | $1320.00 | 1902447386 - SEATTLE PAIN RELIEF PLLC, FEDERAL WAY AMBULATORY SURGICAL FACILITY | 455527273 - (WA) SEATTLE PAIN RELIEF PLLC | WA | 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 54348 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54348 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 54348 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 |
|---|---|---|
| 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) |
| 54406-CPT | Moderate | Removal Of All Components Of Multi-Component, Inflatable Penile Prosthesis Without Replacement Of Prosthesis - Rn Review<6/20/2013 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54348. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54348 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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