CPT 60254 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Endocrine System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 80 - Assistant surgeon • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
National average reimbursement for CPT 60254 by major payers:
$2,072.10
$2,209.66
$2,252.37
$2,758.54
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 60254 | ||||||
United | 60254 | $1296.00 | 1245722883 - WOMENS HEALTH CENTER, HAMID ZADEH MD INC | 473398040 - (CA) WOMENS HEALTH CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $1419.00 | 1811950298 - SOUTH HILL AMBULATORY SURGICAL CENTER PS | 911546856 - (WA) SOUTH HILL AMBULATORY SURGICAL CENTER PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $494.00 | 1386885556 - THE ASC AT WAUGH CHAPEL | 263869837 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $1220.00 | 1538579313 - EYE SURGERY CENTER OF NORTH DALLAS | 462356251 - (TX) EYE SURGERY CENTER OF NORTH DALLAS | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $1425.00 | 1437501145 - NORTH CARE ASC, LLC | 810851059 - (CO) NORTH CARE ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $1834.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $2124.00 | 1306217039 - FIRST HILL SURGERY CENTER LLC | 472066485 - (WA) FIRST HILL SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $3624.00 | 1285912600 - THE EMORY CLINIC INC, THE EMORY CLINIC LAGRANGE SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $1919.00 | 1568776615 - CEDAR PARK SURGERY CENTER, LLC | 272533497 - (TX) CEDAR PARK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $2564.00 | 1447364682 - RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $781.00 | 1891724936 - ARKLAMISS SURGERY CENTER,LLC | 870741444 - (LA) ARKLAMISS SURGERY CENTERLLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $1564.00 | 1780618801 - PINEY ORCHARD SURGERY CENTER, LLC. | 521938770 - (MD) PINEY ORCHARD SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $2795.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $2284.00 | 1063453561 - TEMPLETON SURGERY CENTER, LLC, TEMPLETON SURGERY CENTER | 202246616 - (CA) TEMPLETON SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 60254 | $1700.00 | 1790736502 - SEVEN HILLS SURGERY CENTER, LLC | 203044042 - SEVEN HILLS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 60254 vs. Other Surgical Procedures on the Endocrine System Codes
The CPT 60254 code is part of the Surgery services used for Surgical Procedures on the Endocrine 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 60254 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 60254. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 60254 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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