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See a sample rate comparisonCPT 54400 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.
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.
| 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 GC - Service performed by resident under supervision 22 - Increased Procedural Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54400 |
| Medicaid Fee Schedule | View Medicaid rates for 54400 |
National average reimbursement for CPT 54400 by major payers:
$678.30
$714.71
$747.64
$877.17
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CPT 54400
5 of 25 sample ratesHigher to lower in this preview
Advanced Surgery Center Of Orlando LLC
$25,520.00Published rateWiregrass Ranch Asc Holdings, Wiregrass Ranch Special Procedures Center
Wiregrass Ranch Asc Holdings
$10,000.00Published rateNorthern California Advanced Surgery Center Lp
Northern California Advanced Surgery Center, Lp
$6,385.00Published rateEllicott City Ambulatory Surgery Center, Lllp, Ellicott City Ambulatory Surgery Center
Ellicott City Ambulatory Surgery Center Lllp
$3,708.00Published rateSan Francisco Surgery Center, Lp
$736.00Published rate
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See a sample payer proposalCPT 54400 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54400 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 54400 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 |
|---|---|---|
| 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. |
| 54401-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. |
| 54405-CPT | High | 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. |
| 54406-CPT | Moderate | Remove Muti Comp Penis Pros, Removal Of All Components Of A Multi Component Inflatable Penile Prosthesis Without Replacement Of Prosthesis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54400 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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