2024 Fee Update: Incontinence Therapy for Men Post-Prostatectomy

Published 04/10/2024

Palmetto GBA has completed a fee review for CPT codes 53451, 53452, 53453 and 53454. The code and 2024 fees are listed below. 

53451 (Facility and Non-Facility)

Code

Carrier #

Locality Name

Fee

Effective for Dates of Service

53451

10112

Alabama

$604.72

01/01/24

53451

10212

Georgia (01)

$773.15

01/01/24

53451

10212

Georgia (99)

$744.21

01/01/24

53451

10312

Tennessee

$603.23

01/01/24

53452 (Facility and Non-Facility)

Code

Carrier #

Locality Name

Fee

Effective for Dates of Service

53452

10112

Alabama

$453.67

01/01/24

53452

10212

Georgia (01)

$580.03

01/01/24

53452

10212

Georgia (99)

$558.32

01/01/24

53452

10312

Tennessee

$452.56

01/01/24

53453 (Facility) 

Code

Carrier #

Locality Name

Fee

Effective for Dates of Service

53453

10112

Alabama

$150.06

01/01/24

53453

10212

Georgia (01)

$191.85

01/01/24

53453

10212

Georgia (99)

$184.67

01/01/24

53453

10312

Tennessee

$149.69

01/01/24

53453 (Non-Facility)

Code

Carrier #

Locality Name

Fee

Effective for Dates of Service

53453

10112

Alabama

$177.20

01/01/24

53453

10212

Georgia (01)

$226.55

01/01/24

53453

10212

Georgia (99)

$218.07

01/01/24

53453

10312

Tennessee

$176.76

01/01/24

53454 (Facility) 

Code

Carrier #

Locality Name

Fee

Effective for Dates of Service

53454

10112

Alabama

$28.02

01/01/24

53454

10212

Georgia (01)

$35.83

01/01/24

53454

10212

Georgia (99)

$34.48

01/01/24

53454

10312

Tennessee

$27.95

01/01/24

53454 (Non-Facility)

Code

Carrier #

Locality Name

Fee

Effective for Dates of Service

53454

10112

Alabama

$45.37

01/01/24

53454

10212

Georgia (01)

$58.00

01/01/24

53454

10212

Georgia (99)

$55.83

01/01/24

53454

10312

Tennessee

$45.26

01/01/24

Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage.


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