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See a sample rate comparisonCPT 54512 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.
Excision Of Extraparenchymal Lesion Of Testis
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54512 |
| Medicaid Fee Schedule | View Medicaid rates for 54512 |
National average reimbursement for CPT 54512 by major payers:
$728.32
$717.27
$769.39
$878.91
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CPT 54512
5 of 25 sample ratesHigher to lower in this preview
Riverwalk Asc, LLC, Riverwalk Asc
$6,651.00Published rateSeaside Surgery Center, LLC
Seaside Surgery Center LLC
$2,206.00Published rateFresenius Access Care Physicians Of Madison Asc LLC
$1,331.00Published rateAlliance Surgery Center At Cumming
$900.00Published rateBarnet Dulaney Perkins Eye Center, PC, American Vision Partners
Barnet Dulaney Perkins Eye Center PLLC
$507.00Published rate
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See a sample payer proposalCPT 54512 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54512 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 54512 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 |
|---|---|---|
| 54500-CPT | Low | Biopsy Testis Needle |
| 54505-CPT | Moderate | Biopsy Testis Incisional Unilat |
| 54512-CPT | Moderate | Excision Of Extraparenchymal Lesion Of Testis |
| 54520-CPT | Moderate | Remove All Or Part Of Testicle, Surgery To Remove An Entire Testicle Or Part Of One (Orchiectomy). If Infection Or Injury Is Present It Is Treated. Any Tumor Or Abnormal Tissue Is Removed. The Procedure May Include Placement Of An Artificial Testicle. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54512. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54512 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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