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See a sample rate comparisonHealthcare 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.
| 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 51 - Multiple procedures KX - Requirements specified in the medical policy have been met |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55150 |
| Medicaid Fee Schedule | View Medicaid rates for 55150 |
National average reimbursement for CPT 55150 by major payers:

$622.65

$650.85

$696.83

$803.55
Choose a payer to see a sample of rates for CPT 55150.
Palm Beach International Surgery Center LLC
Main Line Surgery Center
Aesthetic Plastic Surgery Institute
Eagle Physicians & Associates, P.A.
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 55150 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55150 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 55150 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 |
|---|---|---|
| 55110-CPT | Moderate | Scrotal Exploration |
| 55120-CPT | Moderate | Removal Fb Scrotum |
| 55150-CPT | Moderate | Surgery On The Scrotum, Surgical Removal Of Excess Or Diseased Skin From The Scrotum. The Procedure May Involve Skin Grafts For Reconstruction. |
| 55175-CPT | Moderate | Surgery On The Scrotum, Surgery To Repair Or Reconstruct The Scrotum. The Procedure May Include Use Of Skin Grafts Flaps Or Patches. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55150. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55150 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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