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See a sample rate comparisonCPT 54690 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.
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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54690 |
| Medicaid Fee Schedule | View Medicaid rates for 54690 |
National average reimbursement for CPT 54690 by major payers:
$849.67
$890.59
$931.68
$1,085.62
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CPT 54690
5 of 25 sample ratesHigher to lower in this preview
Lake Spivey Ambulatory Surgery Care, LLC, Spivey Station Surgery Center
Emory University
$8,535.00Published rateNew Horizons Surgery Center LLC
$6,365.00Published rateAmbulatory Surgery Center Of Spartanburg, LLC
Ambulatory Surgery Center Of Spartanburg
$3,686.00Published rateNovamed Surgery Center Of Cleveland LLC, The Surgery Center Of Cleveland
Novamed Surgery Center Of Cleveland LLC
$2,350.00Published rateMaryland Aesthetic And Reconstructive Ambulatory Surgical Center LLC
$799.00Published rate
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See a sample payer proposalCPT 54690 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54690 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 54690 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 54690. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54690 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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