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See a sample rate comparisonCPT 54390 Fee Schedule
Last Verified: October 2026
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.
Reconstruct Penis And Urethra, Surgery To Construct A Single Urethra Opening In The Penis As Well As Reconstruct A Bladder That Has Formed Inside-Out (Exstrophy). The Surgery Involves Major Reconstruction Of The Bladder And Passages From The Kidneys (Ureters).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 22 - Increased Procedural Services 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 54390 |
| Medicaid Fee Schedule | View Medicaid rates for 54390 |
National average reimbursement for CPT 54390 by major payers:
$1,547.79
$1,657.19
$1,728.87
$2,025.79
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CPT 54390
5 of 25 sample ratesHigher to lower in this preview
Castle Hills Surgicare, LLC
Castle Hills Surgicare LLC
$8,238.00Published rateSouthern Surgery Center, LLC
Southern Surgery Center LLC
$3,222.00Published rateMedical Heights Surgery Center, Inc., Kentucky Surgery Center
Baptist Health Surgery Center, L
$1,990.00Published rateChildren'S Surgery Center Of Lehigh Valley, LLC
Childrens Surgery Center Of Lehigh Valley LLC
$1,168.00Published rateArizona Digestive Center, P.C.
Arizona Digestive Center PC
$743.00Published rate
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See a sample payer proposalCPT 54390 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54390 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 54390 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 |
|---|---|---|
| 54385-CPT | High | Reconstruct Penis And Urethra, Surgery To Correct A Urethra That Has Formed With An Extra Opening. The Condition May Cause Incontinence. Surgery Closes The Additional Opening And Ensures Urine Flows Properly Out The Penis. |
| 54390-CPT | High | Reconstruct Penis And Urethra, Surgery To Construct A Single Urethra Opening In The Penis As Well As Reconstruct A Bladder That Has Formed Inside-Out (Exstrophy). The Surgery Involves Major Reconstruction Of The Bladder And Passages From The Kidneys (Ureters). |
| 54400-CPT | Moderate | Penis Implant Surgery, Surgery To Implant A Prosthesis Into The Penis. A Prosthesis May Be Semi-Rigid Or Inflatable. The Inflatable Prosthesis May Include A Pump And Reservoir As Well. |
| 54411-CPT | High | Remov Replc Penis Pros Comp, Removal And Replacement Of All Components Of A Multi Component Inflatable Penile Prosthesis Through An Infected Field At The Same Operative Session Including Irrigation And Debridement Of Infected Tissue |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54390. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54390 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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