| Code | Description | States | Median rate |
|---|---|---|---|
| 54000 | Foreskin slit, newborn | 47 | $129.92 |
| 54015 | Drainage of a deep penis abscess | 48 | $242.78 |
| 54056 | Destruction of genital warts by freezing or cautery, simple | 48 | $111.52 |
| 54065 | Destruction of penis lesions, extensive | 47 | $180.08 |
| 54110 | Removal of penile plaque (Peyronie's) | 48 | $504.83 |
| 54115 | Removal of a foreign body from deep penis tissue | 45 | $378.14 |
| 54120 | Partial removal of the penis | 48 | $499.56 |
| 54125 | Complete removal of the penis | 46 | $666.95 |
| 54150 | Circumcision with clamp, newborn | 45 | $125.40 |
| 54160 | Circumcision by surgical excision, newborn | 44 | $181.67 |
| 54161 | Circumcision, older than 28 days | 48 | $162.20 |
| 54162 | Release of adhesions after circumcision | 47 | $216.73 |
| 54164 | Penis frenulum release | 47 | $153.82 |
| 54200 | Injection for Peyronie's disease | 47 | $92.38 |
| 54230 | Injection for a penis X-ray | 41 | $81.25 |
| 54231 | Penile pressure test with drug injection | 38 | $117.67 |
| 54235 | Penile injection for erection testing | 38 | $73.17 |
| 54240 | Penile blood flow measurement (plethysmography) | 34 | $84.90 |
| 54250 | Nighttime erection test | 33 | $98.91 |
| 54380 | Epispadias repair | 48 | $643.35 |
| 54400 | Penile implant insertion, semi-rigid | 25 | $428.84 |
| 54401 | Penile implant insertion, inflatable, self-contained | 23 | $504.81 |
| 54405 | Penile implant insertion, multi-part inflatable | 26 | $592.74 |
| 54406 | Multi-part penile implant removal, no replacement | 35 | $581.28 |
| 54408 | Multi-part penile implant repair | 26 | $610.57 |
| 54410 | Multi-part penile implant replacement, same session | 27 | $689.47 |
| 54411 | Multi-part penile implant replacement for infection | 25 | $767.09 |
| 54415 | Penile implant removal, semi-rigid or self-contained | 34 | $430.80 |
| 54416 | Penile implant replacement, semi-rigid or self-contained | 28 | $556.00 |
| 54417 | Penile implant replacement for infection, semi-rigid type | 28 | $690.61 |
| 54437 | Repair of a penile fracture | 48 | $547.20 |
| 54440 | Penis reconstruction after injury | 40 | $633.17 |
| 54450 | Foreskin stretching and adhesion release | 46 | $59.65 |
| 54500 | Needle biopsy of the testicle | 48 | $63.08 |
| 54522 | Partial testicle removal | 47 | $484.24 |
| 54650 | Undescended testicle repair, abdominal approach | 47 | $570.08 |
| 54660 | Testicle implant insertion | 36 | $291.90 |
| 54670 | Repair of a testicle injury | 48 | $334.02 |
| 54700 | Drainage of a scrotal abscess or blood collection | 48 | $176.51 |
| 54800 | Needle biopsy of the epididymis | 48 | $108.14 |
| 54830 | Removal of an epididymis lesion | 48 | $291.47 |
| 54840 | Removal of a sperm cyst (spermatocele) | 48 | $279.23 |
| 54860 | Removal of the epididymis, one side | 48 | $342.97 |
| 54861 | Removal of the epididymis, both sides | 48 | $463.90 |
| 54865 | Exploration of the epididymis | 48 | $284.70 |
| 54900 | Epididymis-to-vas deferens reconnection, one side | 33 | $637.54 |
| 54901 | Epididymis-to-vas deferens reconnection, both sides | 34 | $851.20 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.