Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 54830 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.
Surgery On Testicle, Surgery To Remove Abnormal Tissue Or A Fluid Sac (Spermatocele) From Around The Epididymis In The Testicle. The Epididymis Stores And Transports Sperm.
| 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 54830 |
| Medicaid Fee Schedule | View Medicaid rates for 54830 |
National average reimbursement for CPT 54830 by major payers:
$507.44
$492.63
$537.81
$609.23
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 54830.
CPT 54830
5 of 25 sample ratesHigher to lower in this preview
Hss Asc Of Manhattan LLC, Hss Asc Of Manhattan
$4,386.00Published rateSansum Clinic, Foothill Surgery Center At Sansum Clinic
Sansum Clinic
$2,337.00Published rateOn Beach Surgery Center, LLC
On Beach Surgery Center LLC
$1,380.00Published rateThe Alexandria Ophthalmology Asc LLC, Wallace Laser And Surgery Center
$1,172.00Published rateKristi Cottrell
Deaconess Hospital Inc
$306.98Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 54830 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54830 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 54830 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 |
|---|---|---|
| 54800-CPT | Low | Sperm Storage Tube Biopsy, A Procedure To Remove A Sample Of Tissue For Testing (Biopsy) From The Epididymis (At The Back Of The Testicles). The Epididymis Stores And Transports Sperm. |
| 54830-CPT | Moderate | Surgery On Testicle, Surgery To Remove Abnormal Tissue Or A Fluid Sac (Spermatocele) From Around The Epididymis In The Testicle. The Epididymis Stores And Transports Sperm. |
| 54840-CPT | Moderate | Surgery On Testicle, Surgery To Remove Abnormal Tissue Or A Fluid Sac (Spermatocele) From Around The Epididymis In The Testicle. The Epididymis Stores And Transports Sperm. |
| 54860-CPT | Moderate | Remove Epididymis (Sperm Tube), Surgery To Remove One Or Both Tubes From The Back Of The Testicles (Epididymis). The Epididymis Stores And Transports Sperm. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54830 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 54830) and we'll show you how you compare in 15 minutes or less.