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Epispadias Repair With Urinary Leakage

Florida rates for HCPCS 54385

Reconstructive surgery on the penis for epispadias, a birth defect in which the urinary opening lies along the top of the penis instead of at the tip. This version is performed when the child also cannot hold urine, so the repair extends to the outlet of the bladder as well as the penis. It is usually done in early childhood and may be staged.

Facilitymedian $4,898 · 10th–90th $1,000$10,9650%5%10%10th90th$4,898Professionalmedian $1,047 · 10th–90th $813$1,6980%10%20%10th90th$1,047$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$4,570.88
Typical High
$10,471.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,047.13
Typical High
$1,698.24
AvMed
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,344.23
Typical High
$11,220.18
AvMed
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$977.24
Typical High
$1,148.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$954.99
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,230.27
Typical High
$1,995.26
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$6,309.57
Typical High
$11,748.98
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$645.65
Typical High
$1,096.48
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$7,413.10
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,148.15
Typical High
$2,041.74
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$954.99