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See a sample rate comparisonCPT 54406 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.
Remove Muti Comp Penis Pros, Removal Of All Components Of A Multi Component Inflatable Penile Prosthesis Without Replacement Of Prosthesis
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 78 - Return to OR - related procedure 52 - Reduced Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54406 |
| Medicaid Fee Schedule | View Medicaid rates for 54406 |
National average reimbursement for CPT 54406 by major payers:
$942.19
$973.78
$1,032.25
$1,193.09
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CPT 54406
5 of 25 sample ratesHigher to lower in this preview
Franconia-Springfield Surgery Center, LLC, Inova Surgery Center @ Franconia-Springfield
Inova Ambulatory Surgical Centers
$6,290.00Published rateCorpus Christi Surgicare Ltd, Christus Spohn Texas Orthopedic Center Of Excellence
Corpus Christi Surgicare Ltd
$3,570.00Published rateAuburn Surgery Center Inc
$2,100.00Published rateHattiesburg Clinic PA, Ambulatory Surgery Center
Hattiesburg Clinic, P.A.
$1,209.00Published rateLaressa Bazzell
Deaconess Hospital Inc
$603.51Published rate
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See a sample payer proposalCPT 54406 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54406 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 54406 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 |
|---|---|---|
| 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 |
| 54408-CPT | Moderate | Rpair Of Compone(S) Of A Multi-Compone Inflate Penile Prosthe, Repair Of Component(S) Of A Multi-Component Inflatable Penile Prosthe |
| 54410-CPT | High | Remove Replace Penis Prosth, Removal And Replacement Of All Component S Of A Multi Component Inflatable Penile Prosthesis At The Same Operative Session |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54406 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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