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See a sample rate comparisonCPT 54415 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 Self Contd Penis Pros, Removal Of Non Inflatable Semi Rigid Or Inflatable Self Contained 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 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54415 |
| Medicaid Fee Schedule | View Medicaid rates for 54415 |
National average reimbursement for CPT 54415 by major payers:
$654.72
$703.24
$745.58
$868.00
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CPT 54415
5 of 25 sample ratesHigher to lower in this preview
Ophthalmology Surgery Center Of Dallas, LLC
Ophthalmology Surgery Center Of Dallas
$6,342.00Published rateSpecialists One- Day Surgery LLC, Specialists One-Day Surgery
Specialists One Day Surgery LLC
$3,058.00Published rateKy Advanced Surgical Center Inc
$1,800.00Published ratePacific Eye Institute A Medical Group Inc, Pacific Eye Institute Ambulatory Surgery Ctr
Pacific Eye Institute Medical Corporation
$1,477.00Published rateAmbulatory Surgical Care, LLC
Ambulatory Surgical Care LLC
$550.00Published rate
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See a sample payer proposalCPT 54415 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54415 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 54415 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 |
| 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 |
| 54415-CPT | Moderate | Remove Self Contd Penis Pros, Removal Of Non Inflatable Semi Rigid Or Inflatable Self Contained 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 54415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54415 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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