CPT 54352 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 • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 54352 |
National average reimbursement for CPT 54352 by major payers:
$1,771.36
$1,917.09
$2,056.84
$2,379.40
| 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 54352 | ||||||
United | 54352 | $1457.00 | 1285630160 - NOVAMED EYE SURGERY CENTER OF NORTH COUNTY, LLC, WOODCREST SURGERY CENTER | 364111316 - (MO) NOVAMED EYE SURGERY CENTER OF NORTH COUNTY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $3585.00 | 1508197039 - FREEMAN SURGICAL CENTER LLC | 431704371 - FREEMAN HEALTH SYSTEM | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $2749.00 | 1043690126 - BELLINGHAM UROLOGY GROUP, PLLC | 472435308 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $1257.00 | 1255746087 - OSI, LLC | 352509822 - (MI) OSI, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $1547.00 | 1962080853 - NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER LLC, NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER | 862943847 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $5433.00 | 1306421268 - COLORADO UROLOGIC SURGERY CENTER, LLC, COLORADO UROLOGIC SURGERY CENTER | 851926897 - (CO) COLORADO UROLOGIC SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $3690.00 | 1861782591 - CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC, CAMIS | 270907140 - (NJ) CENTER FOR AMBULATORY AND MINI | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $1828.00 | 1144650060 - SAN ANTONIO CHILDRENS SURGICAL | 464050149 - (TX) SAN ANTONIO CHILDRENS SURGICAL | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $3000.00 | 1225023021 - ARC OF GEORGIA, LLC, PREMIER SURGERY CENTER | 621746313 - (GA) ARC OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $7718.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $1320.00 | 1295142511 - BAY AREA ENDOSCOPY CENTER LLC | 463916191 - (CA) BAY AREA ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $5779.00 | 1619218096 - SAN MARCOS ASC LLC | 800899088 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $4475.00 | 1548280209 - SHORT HILLS SURGERY CENTER, LLC, SHORT HILLS SURGERY CENTER | 721572665 - (NJ) SHORT HILLS SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $2555.00 | 1134687981 - ARMENIA AMBULATORY SURGICAL CENTER, LLC | 833888664 - (FL) ARMENIA AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54352 | $1700.00 | 1740288679 - GULF COAST SURGICAL PARTNERS LLC | 631285913 - (AL) GULF COAST SURGICAL PARTNERS LLC | AL | 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 54352 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54352 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 54352 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 |
|---|---|---|
| 54300-CPT | Moderate | Plastic Operation Of Penis For Straightening Of Chordee (Eg, Hypospadias), With Or Without Mobilization Of Urethra; |
| 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) |
| 54410-CPT | High | Removal & Replacement Of All Component Of Multi-Component, Inflatable Penile Prosthesis At Same Operative Session - 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 54352. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54352 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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