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See a sample rate comparisonCPT 54680 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.
Transplnt Of Testis(Es) To Thigh (Because Of Scrotal Destruct, Transplantation Of Testis(Es) To Thigh (Because Of Scrotal Destruction
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 50 - Bilateral Procedure 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54680 |
| Medicaid Fee Schedule | View Medicaid rates for 54680 |
National average reimbursement for CPT 54680 by major payers:
$984.90
$1,052.04
$1,084.80
$1,284.12
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CPT 54680
5 of 25 sample ratesHigher to lower in this preview
Saint Vincent Hlth Ctr Spu
Highmark Health
$8,704.79Published rateGold Coast Surgery Center LLC, Gulf Comprehensive Surgery Center
Gold Coast Surgery Center LLC
$2,353.00Published rateAdvocate Condell Ambulatory Surgery Center, LLC
Advocate Condell Ambulatory Surgery Center LLC
$2,000.00Published rateAssociates Surgery Centers, LLC
Associates Surgery Centers LLC
$814.00Published rateCentral Arizona Endoscopy LLC
$598.00Published rate
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See a sample payer proposalCPT 54680 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54680 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 54680 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 |
|---|---|---|
| 54660-CPT | Moderate | Insertion Of Testicular Prosthesis--Sepa |
| 54670-CPT | Moderate | Suture/Repair Of Testicular Injury |
| 54680-CPT | Moderate | Transplnt Of Testis(Es) To Thigh (Because Of Scrotal Destruct, Transplantation Of Testis(Es) To Thigh (Because Of Scrotal Destruction |
| 54690-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 54680. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54680 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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