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See a sample rate comparisonCPT 54560 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.
Explor Abdom Undescen Testis Unilat
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54560 |
| Medicaid Fee Schedule | View Medicaid rates for 54560 |
National average reimbursement for CPT 54560 by major payers:
$914.75
$916.84
$945.15
$1,123.58
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CPT 54560
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Northwest, LLP, Memorial Hermann Surgery Center Greater Heights
Memorial Hermann Surgery Center Northwest LLP
$5,048.00Published rateAmarillo Endoscopy Center, Lp
Amarillo Endoscopy Center Lp
$2,353.00Published ratePacific Gastroenterology Endoscopy Center
$1,500.00Published rateThe Plastic Surgery Center Land, LLC
The Plastic Surgery Center Land LLC
$1,055.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$691.00Published rate
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See a sample payer proposalCPT 54560 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54560 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 54560 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 |
|---|---|---|
| 54550-CPT | Moderate | Explora For Undescended Testis (Inguinal Or Scrotal Area), Exploration For Undescended Testis (Inguinal Or Scrotal Area) |
| 54560-CPT | Moderate | Explor Abdom Undescen Testis Unilat |
| 54600-CPT | Moderate | Surgery For Twisted Sperm Cord, Surgery To Untwist A Testicle That Has Wound Around Itself Cutting Off Blood Supply. The Testicle Is Anchored To The Wall Of The Scrotum To Prevent Another Occurrence. The Other Testicle May Be Anchored As Well. |
| 54620-CPT | Moderate | Surgery For Twisted Sperm Cord, Surgery To Untwist A Testicle That Has Wound Around Itself Cutting Off Blood Supply. The Testicle Is Anchored To The Wall Of The Scrotum To Prevent Another Occurrence. The Other Testicle May Be Anchored As Well. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54560 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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