CPT 54408 Fee Schedule
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.
| 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 78 - Return to OR - related procedure AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54408 |
National average reimbursement for CPT 54408 by major payers:
$961.23
$1,050.47
$1,107.15
$1,287.64
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 54408 | $1355.00 | 1669481255 - SURGERY CENTER OF CULLMAN LLC, HEALTHSOUTH/WOODLANDS SURGERY CENTER OF CULLMAN, LLC | 203489003 - (AL) SURGERY CENTER OF CULLMAN LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $1457.00 | 1366496143 - VIRGINIA SURGERY CENTER, LLC, CVP SURGERY CENTER | 541922041 - (VA) VIRGINIA SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $7770.00 | 1497312540 - MEMORIAL HERMANN SURGERY CENTER MAIN STREET, LLC | 384114079 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $3200.00 | 1528377678 - NORTH TEXAS TEAM CARE SURGERY CENTER LLC | 271832985 - (TX) NORTH TEXAS TEAM CARE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $4106.00 | 1457682841 - PAIN CARE OF NORTH TEXAS | 200081985 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $7770.00 | 1336391085 - MEMORIAL HERMANN SURGERY CENTER KINGSLAND LLC, MEMORIAL HERMANN SURGERY CENTER KINGSLAND | 263464776 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $2840.00 | 1669720397 - PLEASANT VIEW SURGERY CENTER, LLC | 455254219 - (ID) PLEASANT VIEW SURGERY CENTER, LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $3268.00 | 1689699597 - NAPA SURGERY CENTER LLC | 680366295 - (CA) NAPA SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $2350.00 | 1730514027 - KY ADVANCED SURGICAL CENTER INC | 901005366 - (CA) KY ADVANCED SURGICAL CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $1665.00 | 1790744175 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PUYALLUP ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $1300.00 | 1750468583 - TEXAS EYE SURGERY CENTER, LLC | 202928367 - (TX) TEXAS EYE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $2700.00 | 1972232981 - SOUTHPOINT SURGERY CENTER LLC | 841989776 - (NC) SOUTHPOINT SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $3690.00 | 1013136456 - SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC, ADVANCED SURGICAL INSTITUTE | 204481032 - (NJ) SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $2996.00 | 1801944343 - HUDSON VALLEY AMBULATORY SURGERY, LLC | 510451539 - (NY) HUDSON VALLEY AMBULATORY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 54408 | $2229.00 | 1699767210 - SOUTHERN OKLAHOMA SURGICAL CENTER INC | 731205988 - (OK) SOUTHERN OKLAHOMA SURGICAL CENTER, INC. | OK | 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 54408 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54408 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 54408 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 |
|---|---|---|
| 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 |
| 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 54408. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54408 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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