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See a sample rate comparisonCPT 54411 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.
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
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 54411 |
| Medicaid Fee Schedule | View Medicaid rates for 54411 |
National average reimbursement for CPT 54411 by major payers:
$1,336.88
$1,362.51
$1,424.96
$1,669.74
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CPT 54411
5 of 25 sample ratesHigher to lower in this preview
Ambulatory Surgery Center Group Ltd
$2,965.00Published rateSurgcenter Of Glen Burnie, Surgcenter Of Glen Burnie, LLC
Surgcenter Of Glen Burnie, LLC
$574.00Published rateTampa Bay Specialty Surgery Center LLC, Tampa Bay Specialty Surgery Center
Tampa Bay Specialty Surgery Center LLC
$330.00Published rateBaton Rouge Vascular Access Asc LLC
$150.00Published rateBoston Eye Surgery & Laser Center Trust, Boston Eye Surgery & Laser Center
Boston Eye Surgery & Laser Center Trust
$66.00Published rate
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See a sample payer proposalCPT 54411 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54411 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 54411 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 54411. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54411 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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