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See a sample rate comparisonCPT 54420 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.
Release Of Prolonged Erection, One Of Various Surgeries Designed To Correct Uncontrolled Or Abnormal Blood Flow To The Penis Thus Releasing A Prolonged Erection (Priapism).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 23 - Emergency Room 21 - Inpatient Hospital |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54420 |
| Medicaid Fee Schedule | View Medicaid rates for 54420 |
National average reimbursement for CPT 54420 by major payers:
$887.28
$942.56
$970.88
$1,178.75
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CPT 54420
5 of 25 sample ratesHigher to lower in this preview
Bayonet Point Surgery Center Ltd
$6,734.00Published rateOphthalmology Surgery Center Of Orlando LLC, Orlando Ophthalmology Surgery Center
$3,500.00Published rateOrthoillinois Surgery Center Elgin, LLC
Orthoillinois Surgery Center Elgin LLC
$2,499.00Published rateMark Fromer, LLC, Eye Surgery Centers Of New York
Mark Fromer LLC
$1,987.00Published rateJohns Creek Center For Pain And Spine
$950.00Published rate
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See a sample payer proposalCPT 54420 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54420 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 54420 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 |
|---|---|---|
| 54420-CPT | Moderate | Release Of Prolonged Erection, One Of Various Surgeries Designed To Correct Uncontrolled Or Abnormal Blood Flow To The Penis Thus Releasing A Prolonged Erection (Priapism). |
| 54430-CPT | Moderate | Release Of Prolonged Erection, One Of Various Surgeries Designed To Correct Uncontrolled Or Abnormal Blood Flow To The Penis Thus Releasing A Prolonged Erection (Priapism). |
| 54435-CPT | Moderate | Release Of Prolonged Erection, One Of Various Surgeries Designed To Correct Uncontrolled Or Abnormal Blood Flow To The Penis Thus Releasing A Prolonged Erection (Priapism). |
| 54437-CPT | Moderate | Repair Of Traumatic Corporeal, Repair Of Traumatic Corporeal Tear(S) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54420 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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