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See a sample rate comparisonCPT 54535 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.
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.
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 54535 |
| Medicaid Fee Schedule | View Medicaid rates for 54535 |
National average reimbursement for CPT 54535 by major payers:
$1,020.91
$991.31
$1,024.05
$1,215.41
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CPT 54535
5 of 25 sample ratesHigher to lower in this preview
Foothills Surgery Center, LLC
$4,727.00Published rateAndochick Surgical Center LLC, Physicians Surgery Center Of Frederick
Andochick Surgical Center LLC
$2,441.00Published rateSouthwest Atlanta Vascular Care, LLC
Southwest Atlanta Vascular Care LLC
$1,699.00Published rateSutter Amador Surgery Center LLC, Sutter Amador Surgery Center
$1,072.50Published rateAsc Development Company, LLC, National Spine And Pain Centers
Asc Development Company LLC
$765.00Published rate
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See a sample payer proposalCPT 54535 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54535 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 54535 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 |
| 54535-CPT | High | 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 54535. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54535 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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