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Epispadias Repair With Urinary Leakage

Tennessee 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.

Rates data updated July 2026.

How much does Epispadias Repair With Urinary Leakage cost?

$1,380

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $1,380 for this service. The price depends on where it is billed: about $1,288 from a physician practice, and about $2,951 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,288$955 to $1,479
FacilityA hospital or hospital-owned outpatient department$2,951$2,089 to $4,266

How much rates vary

Facilitymedian $2,951 · 10th to 90th $1,175 to $6,607Professionalmedian $1,288 · 10th to 90th $912 to $2,818
$200.0$1.0K$5.0K$20.0Kfacility $2,951professional $1,288

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$2,398.83
Typical High
$6,456.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,174.90
Typical High
$1,659.59
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$2,951.21
Typical High
$3,981.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,412.54
Typical High
$2,238.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,258.93
Typical High
$1,862.09
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$5,754.40
Median
$5,754.40
Typical High
$45,708.82
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$8,511.38
Median
$8,511.38
Typical High
$8,511.38
United
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,466.84
Typical High
$7,585.78
United
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,318.26
Typical High
$2,089.30

Where Tennessee sits

The same service costs 6.2 times more in California than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Tennessee $1,380 · 33rd of 51
CA $6,457WV $1,047

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.