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CPT code 53454: Balloon device adjustment, transperineal continence device2026 Medicare rate & RVUs

Reports adjustment of an implanted transperineal balloon continence device, typically to manage persistent urinary leakage in a patient with the device.

CMS RVU26DEffective Oct 1, 2026109 payment localities645 Medicare services in 2024

Medicare rate · 53454

Balloon device adjustment, transperineal continence device

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
000

National rate · 2026

—

Not priced in the facility setting.

See every locality for 53454 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 53454 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 53454 covers

A urologist adjusts the fluid volume in an implanted transperineal balloon continence device to change its support around the urethra and improve urinary control. The device is used for stress urinary incontinence, including in men with leakage after prostate treatment. Adjustment may take place in an office or facility setting; this service concerns an existing device, not its initial placement or removal.

Medicare assigns this CPT code physician fee schedule status C, or carrier priced: the Medicare Administrative Contractor sets payment for each claim rather than CMS publishing a national amount. The code has a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this adjustment. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 53454 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

53454 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

53454 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
53454 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 53454 rate is calculated

Each of 53454’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 53454

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 53454

The CMS indicators that decide how 53454 is paid alongside other services.

CMS payment indicators · 53454

Balloon device adjustment, transperineal continence device

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

53454 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 53454

    Balloon device adjustment, transperineal continence device0 wRVU

    Not priced

  • 53451

    Balloon device placement, bilateral placement0 wRVU

    Not priced

  • 53452

    Continence balloon, unilateral insertion0 wRVU

    Not priced

  • 53453

    Balloon device removal, each balloon0 wRVU

    Not priced

  • 53445

    Artificial sphincter, initial inflatable device placement12.68 wRVU

    Not priced

How to choose

53451Balloon device placementBilateral placement
53451 describes bilateral device placement. This code describes adjustment of a device that is already implanted.
53452Continence balloonUnilateral insertion
53452 describes unilateral device placement. Use this code for subsequent adjustment, not initial placement.
53453Balloon device removalEach balloon
53453 is for device removal; this code is for adjustment without describing removal.
53445Artificial sphincterInitial inflatable device placement
53445 describes implantation of an artificial urinary sphincter, a different device. This code concerns adjustment of transperineal continence balloons.

Codes related to 53454

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 53454
CodeHow it relatesNational office range
Same family
53451Balloon device placement, bilateral placementBilateral placement of the transperineal balloon continence device.No office rate
53452Continence balloon, unilateral insertionUnilateral placement of the transperineal balloon continence device.No office rate
Used instead
53440Male sling, male stress incontinenceMale sling procedure is another surgical approach to male urinary incontinence.No office rate
53445Artificial sphincter, initial inflatable device placementArtificial urinary sphincter implantation is another surgical treatment for urinary incontinence.No office rate

53454 billing questions

When should I report this code instead of 53451 or 53452?

Report this code for adjustment of an already implanted transperineal balloon continence device. Codes 53451 and 53452 describe initial bilateral and unilateral placement, respectively.

How does this differ from 53453?

This code describes adjusting the implanted device. Code 53453 describes removal of a transperineal balloon continence device.

Should modifier 50 be appended for adjustment of both balloons?

No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What Medicare payment status applies?

The physician fee schedule status is C, or carrier priced. The Medicare Administrative Contractor sets payment for each claim.

Can an assistant-at-surgery or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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