CPT code 54055: Penile lesion destruction, extensive treatment2026 Medicare rate & RVUs in Washington, DC area
Reports extensive destruction of penile lesions, such as condyloma, when treatment goes beyond simple chemical destruction of a limited lesion.
In Washington, DC area, Medicare pays $158.72 for 54055 in the office and $96.94 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 54055 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 54055 covers
This service covers extensive destruction of lesions on the penis, commonly condyloma (genital warts). A urologist, dermatologist, or other qualified clinician may perform it in an office or procedure setting using an ablative approach such as electrosurgery. The extent of treatment, rather than a particular lesion count, distinguishes it from simple chemical destruction; technique-specific cryosurgery and laser codes are also available.
Report the service when the documented lesion burden and treatment support extensive destruction. Record the penile site, lesion distribution, method, and work performed. The service has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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.
How Washington, DC area compares for 54055
Across 109 of 109 payment localities, the office rate for 54055 runs from $123.78 in Arkansas to $183.08 in San Benito County, CA. Washington, DC area pays $158.72. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$158.72
- Los Angeles, CA · California$156.56−$2.16
- Miami, FL · Florida$150.28−$8.44
- Chicago, IL · Illinois$146.09−$12.63
- Manhattan, NY · New York$159.83+$1.11
- Alaska · Alaska$163.66+$4.94
- Alabama · Alabama$125.52−$33.20
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $123.78 | $78.73 |
| ArizonaArizona | $135.70 | $84.89 |
| Bakersfield, CACalifornia | $147.24 | $89.76 |
| Chico, CACalifornia | $146.81 | $89.34 |
| El Centro, CACalifornia | $146.84 | $89.36 |
| Fresno, CACalifornia | $146.81 | $89.34 |
| Hanford, CACalifornia | $146.81 | $89.34 |
| Madera, CACalifornia | $146.81 | $89.34 |
| Merced, CACalifornia | $146.81 | $89.34 |
| Modesto, CACalifornia | $146.81 | $89.34 |
| Napa, CACalifornia | $169.39 | $100.28 |
| Oxnard, CACalifornia | $155.74 | $93.76 |
| Redding, CACalifornia | $146.81 | $89.34 |
| Rest of CaliforniaCalifornia | $146.81 | $89.34 |
| Riverside, CACalifornia | $148.34 | $90.86 |
| Sacramento, CACalifornia | $153.88 | $92.89 |
| Salinas, CACalifornia | $153.30 | $92.52 |
| San Diego, CACalifornia | $156.76 | $94.04 |
| Marin County, CACalifornia | $179.10 | $105.16 |
| San Francisco, CACalifornia | $178.95 | $105.01 |
| San Benito County, CACalifornia | $183.08 | $107.46 |
| Santa Clara County, CACalifornia | $182.43 | $106.81 |
| San Luis Obispo, CACalifornia | $150.85 | $91.12 |
| Santa Cruz, CACalifornia | $158.15 | $94.43 |
| Santa Maria, CACalifornia | $153.83 | $92.69 |
| Santa Rosa, CACalifornia | $159.73 | $95.34 |
| Stockton, CACalifornia | $146.81 | $89.34 |
| Vallejo, CACalifornia | $169.17 | $100.05 |
| Visalia, CACalifornia | $146.81 | $89.34 |
| Yuba City, CACalifornia | $146.81 | $89.34 |
| ColoradoColorado | $144.75 | $88.96 |
| ConnecticutConnecticut | $148.31 | $91.83 |
| DelawareDelaware | $137.89 | $86.08 |
| Fort Lauderdale, FLFlorida | $144.28 | $91.16 |
| Rest of FloridaFlorida | $137.50 | $87.37 |
| Atlanta, GAGeorgia | $141.85 | $88.57 |
| Rest of GeorgiaGeorgia | $130.04 | $83.27 |
| Hawaii, Guam, HIHawaii | $150.17 | $90.55 |
| IowaIowa | $128.48 | $80.50 |
| IdahoIdaho | $129.31 | $81.06 |
| East St. Louis, ILIllinois | $136.51 | $88.27 |
| Rest of IllinoisIllinois | $133.75 | $85.87 |
| Suburban Chicago, ILIllinois | $145.71 | $91.86 |
| IndianaIndiana | $130.03 | $81.42 |
| KansasKansas | $127.95 | $80.55 |
| KentuckyKentucky | $128.47 | $81.85 |
| New Orleans, LALouisiana | $134.38 | $85.03 |
| Rest of LouisianaLouisiana | $128.29 | $81.88 |
| Metropolitan Boston, MAMassachusetts | $158.65 | $96.03 |
| Rest of MassachusettsMassachusetts | $143.96 | $88.74 |
| Baltimore area, MDMaryland | $147.89 | $91.63 |
| Rest of MarylandMaryland | $140.43 | $87.36 |
| Rest of MaineMaine | $130.01 | $81.76 |
| Southern Maine, MEMaine | $136.71 | $84.74 |
| Detroit, MIMichigan | $139.20 | $88.60 |
| Rest of MichiganMichigan | $131.72 | $83.84 |
| MinnesotaMinnesota | $138.71 | $84.75 |
| Metropolitan Kansas City, MOMissouri | $133.45 | $84.21 |
| Metropolitan St. Louis, MOMissouri | $134.79 | $84.86 |
| Rest of MissouriMissouri | $126.21 | $81.01 |
| MississippiMississippi | $125.02 | $79.86 |
| MontanaMontana | $139.27 | $86.83 |
| North CarolinaNorth Carolina | $131.31 | $82.38 |
| North DakotaNorth Dakota | $136.50 | $84.06 |
| NebraskaNebraska | $129.15 | $80.74 |
| New HampshireNew Hampshire | $142.55 | $87.96 |
| Northern New JerseyNew Jersey | $157.18 | $96.35 |
| Rest of New JerseyNew Jersey | $150.00 | $92.74 |
| New MexicoNew Mexico | $132.43 | $84.34 |
| NevadaNevada | $138.59 | $86.10 |
| NYC suburbs and Long Island, NYNew York | $163.64 | $101.29 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $151.01 | $93.59 |
| Queens, NYNew York | $161.04 | $99.06 |
| Rest of New YorkNew York | $133.20 | $83.38 |
| OhioOhio | $131.15 | $83.28 |
| OklahomaOklahoma | $128.20 | $81.37 |
| Portland, OROregon | $149.15 | $90.89 |
| Rest of OregonOregon | $137.52 | $85.29 |
| Metropolitan Philadelphia, PAPennsylvania | $144.77 | $90.18 |
| Rest of PennsylvaniaPennsylvania | $131.33 | $83.19 |
| Puerto RicoPuerto Rico | $140.24 | $87.23 |
| Rhode IslandRhode Island | $142.65 | $88.48 |
| South CarolinaSouth Carolina | $131.45 | $82.99 |
| South DakotaSouth Dakota | $136.18 | $83.74 |
| TennesseeTennessee | $128.58 | $80.91 |
| Austin, TXTexas | $144.27 | $88.79 |
| Beaumont, TXTexas | $130.50 | $82.78 |
| Brazoria, TXTexas | $137.73 | $85.77 |
| Dallas, TXTexas | $138.61 | $86.38 |
| Fort Worth, TXTexas | $137.73 | $86.03 |
| Galveston, TXTexas | $138.15 | $86.07 |
| Houston, TXTexas | $140.71 | $88.64 |
| Rest of TexasTexas | $134.04 | $84.28 |
| UtahUtah | $133.17 | $83.88 |
| VirginiaVirginia | $136.31 | $84.76 |
| Virgin Islands, VIUnited States Virgin Islands | $140.24 | $87.23 |
| VermontVermont | $136.03 | $84.12 |
| Rest of WashingtonWashington | $143.67 | $88.45 |
| King County, WAWashington | $161.77 | $97.43 |
| WisconsinWisconsin | $132.10 | $81.87 |
| West VirginiaWest Virginia | $129.00 | $83.43 |
| WyomingWyoming | $138.07 | $85.63 |
54055 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$123.78
$164.95
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $163.66 | 1 |
| AL | $125.52 | 1 |
| AR | $123.78 | 1 |
| AZ | $135.70 | 1 |
| CA | $146.81–$183.08 | 29 |
| CO | $144.75 | 1 |
| CT | $148.31 | 1 |
| DC | $158.72 | 1 |
| DE | $137.89 | 1 |
| FL | $137.50–$150.28 | 3 |
| GA | $130.04–$141.85 | 2 |
| GU | $150.17 | 1 |
| HI | $150.17 | 1 |
| IA | $128.48 | 1 |
| ID | $129.31 | 1 |
| IL | $133.75–$146.09 | 4 |
| IN | $130.03 | 1 |
| KS | $127.95 | 1 |
| KY | $128.47 | 1 |
| LA | $128.29–$134.38 | 2 |
| MA | $143.96–$158.65 | 2 |
| MD | $140.43–$158.72 | 3 |
| ME | $130.01–$136.71 | 2 |
| MI | $131.72–$139.20 | 2 |
| MN | $138.71 | 1 |
| MO | $126.21–$134.79 | 3 |
| MS | $125.02 | 1 |
| MT | $139.27 | 1 |
| NC | $131.31 | 1 |
| ND | $136.50 | 1 |
| NE | $129.15 | 1 |
| NH | $142.55 | 1 |
| NJ | $150.00–$157.18 | 2 |
| NM | $132.43 | 1 |
| NV | $138.59 | 1 |
| NY | $133.20–$163.64 | 5 |
| OH | $131.15 | 1 |
| OK | $128.20 | 1 |
| OR | $137.52–$149.15 | 2 |
| PA | $131.33–$144.77 | 2 |
| PR | $140.24 | 1 |
| RI | $142.65 | 1 |
| SC | $131.45 | 1 |
| SD | $136.18 | 1 |
| TN | $128.58 | 1 |
| TX | $130.50–$144.27 | 8 |
| UT | $133.17 | 1 |
| VA | $136.31–$158.72 | 2 |
| VI | $140.24 | 1 |
| VT | $136.03 | 1 |
| WA | $143.67–$161.77 | 2 |
| WI | $132.10 | 1 |
| WV | $129.00 | 1 |
| WY | $138.07 | 1 |
How the 54055 rate is calculated
Each of 54055’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 · 54055
RVUs × geographic indexes × conversion factor
Work1.22
1.22 RVUs× 1.000 GPCI
Practice expense2.81
2.81 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
4.1700
Conversion factor
$33.4009
Medicare rate
$139.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,239
- Code
- 54055
- Physician work
- 1.22
- Practice expense
- 2.81
- Malpractice
- 0.14
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.22 | × 1.054 | 1.2859 |
| Practice expense | 2.81 | × 1.178 | 3.3102 |
| Malpractice | 0.14 | × 1.113 | 0.1558 |
| Total RVUs | 4.7519 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$158.72
Office: (1.22 × 1.054 + 2.81 × 1.178 + 0.14 × 1.113) × $33.4009 = $158.72
Facility: (1.22 × 1.054 + 1.24 × 1.178 + 0.14 × 1.113) × $33.4009 = $96.94
Payment rules and modifiers for 54055
54055 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54055
Penile lesion destruction, extensive treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54055
Penile lesion destruction, extensive treatment
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54055 without 51 · national office
$139.28
Penile lesion destruction, extensive treatment
54055-51 · Second procedure: 50%
$69.64
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 54055 has changed in Washington, DC area
54055 · Office / nonfacility
$158.72
Effective 2026-10-01
The base rate is $1.97 higher than on 2025-10-01, moving from $156.75 to $158.72 (1.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$156.75changed to$158.72
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.25 changed to 1.22
- Malpractice RVU 0.15 changed to 0.14
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$159.72changed to$156.75
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.77 changed to 2.81
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$157.12changed to$159.72
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$162.90changed to$157.12
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.70 changed to 2.77
- Malpractice RVU 0.17 changed to 0.15
- Work GPCI 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$163.89changed to$162.90
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.64 changed to 2.70
- Malpractice RVU 0.12 changed to 0.17
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$161.84changed to$163.89
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.54 changed to 2.64
- Malpractice RVU 0.14 changed to 0.12
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$150.70changed to$161.84
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.21 changed to 2.54
- Malpractice RVU 0.13 changed to 0.14
- Work GPCI 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$144.68changed to$150.70
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.08 changed to 2.21
- Malpractice RVU 0.16 changed to 0.13
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$142.35changed to$144.68
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.03 changed to 2.08
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$139.94changed to$142.35
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.98 changed to 2.03
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$138.93changed to$139.94
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.96 changed to 1.98
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$139.84changed to$138.93
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.98 changed to 1.96
- Malpractice RVU 0.15 changed to 0.16
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$139.14changed to$139.84
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$134.44changed to$139.14
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.90 changed to 1.98
- Malpractice RVU 0.13 changed to 0.15
- Work GPCI 1.050 changed to 1.051
- Practice expense GPCI 1.202 changed to 1.205
- Malpractice GPCI 1.205 changed to 1.280
Held through RVU15B.
January 1, 2014
RVU14A
$137.22changed to$134.44
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.14 changed to 1.90
- Malpractice RVU 0.14 changed to 0.13
- Work GPCI 1.049 changed to 1.050
- Practice expense GPCI 1.198 changed to 1.202
- Malpractice GPCI 1.130 changed to 1.205
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $137.22
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $158.72 | $96.94 | RVU26D |
| 2026-07-01 | $158.72 | $96.94 | RVU26C |
| 2026-04-01 | $158.72 | $96.94 | RVU26B |
| 2026-01-01 | $158.72 | $96.94 | RVU26A |
| 2025-10-01 | $156.75 | $108.17 | RVU25D |
| 2025-07-01 | $156.75 | $108.17 | RVU25C |
| 2025-04-01 | $156.75 | $108.17 | RVU25B |
| 2025-01-01 | $156.75 | $108.17 | RVU25A |
| 2024-10-01 | $159.72 | $109.33 | RVU24D |
| 2024-07-01 | $159.72 | $109.33 | RVU24C |
| 2024-04-01 | $159.72 | $109.33 | RVU24B |
| 2024-03-09 | $159.72 | $109.33 | RVU24AR |
| 2024-01-01 | $157.12 | $107.55 | RVU24A |
| 2023-10-01 | $162.90 | $111.06 | RVU23D |
| 2023-07-01 | $162.90 | $111.06 | RVU23C |
| 2023-04-01 | $162.90 | $111.06 | RVU23B |
| 2023-01-01 | $162.90 | $111.06 | RVU23A |
| 2022-10-01 | $163.89 | $109.99 | RVU22D |
| 2022-07-01 | $163.89 | $109.99 | RVU22C |
| 2022-04-01 | $163.89 | $109.99 | RVU22B |
| 2022-01-01 | $163.89 | $109.99 | RVU22A |
| 2021-10-01 | $161.84 | $111.38 | RVU21D |
| 2021-07-01 | $161.84 | $111.38 | RVU21C |
| 2021-04-01 | $161.84 | $111.38 | RVU21B |
| 2021-01-01 | $161.84 | $111.38 | RVU21A |
| 2020-10-01 | $150.70 | $110.16 | RVU20D |
| 2020-07-01 | $150.70 | $110.16 | RVU20C |
| 2020-04-01 | $150.70 | $110.16 | RVU20B |
| 2020-01-01 | $150.70 | $110.16 | RVU20A |
| 2019-10-01 | $144.68 | $109.93 | RVU19D |
| 2019-07-01 | $144.68 | $109.93 | RVU19C |
| 2019-04-01 | $144.68 | $109.93 | RVU19B |
| 2019-01-01 | $144.68 | $109.93 | RVU19A |
| 2018-10-01 | $142.35 | $109.38 | RVU18D |
| 2018-07-01 | $142.35 | $109.38 | RVU18C |
| 2018-04-01 | $142.35 | $109.38 | RVU18B |
| 2018-01-01 | $142.35 | $109.38 | RVU18AR1 |
| 2017-10-01 | $139.94 | $108.80 | RVU17D |
| 2017-07-01 | $139.94 | $108.80 | RVU17C |
| 2017-04-01 | $139.94 | $108.80 | RVU17B |
| 2017-01-01 | $139.94 | $108.80 | RVU17A |
| 2016-10-01 | $138.93 | $107.87 | RVU16D |
| 2016-07-01 | $138.93 | $107.87 | RVU16C |
| 2016-04-01 | $138.93 | $107.87 | RVU16B |
| 2016-01-01 | $138.93 | $107.87 | RVU16A |
| 2015-10-01 | $139.84 | $108.66 | RVU15D |
| 2015-07-01 | $139.84 | $108.66 | RVU15C |
| 2015-04-01 | $139.14 | $108.12 | RVU15B |
| 2015-01-01 | $139.14 | $108.12 | RVU15A |
| 2014-10-01 | $134.44 | $104.73 | RVU14D |
| 2014-07-01 | $134.44 | $104.73 | RVU14C |
| 2014-04-01 | $134.44 | $104.73 | RVU14B |
| 2014-01-01 | $134.44 | $104.73 | RVU14A |
| 2013-10-01 | $137.22 | $105.02 | RVU13D |
| 2013-07-01 | $137.22 | $105.02 | RVU13C |
| 2013-04-01 | $137.22 | $105.02 | RVU13B |
| 2013-01-01 | $137.22 | $105.02 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
54055 billing questions
How does 54055 differ from 54050?
54055 is for extensive destruction. 54050 describes simple chemical destruction, so the documented extent and method help distinguish the services.
When should a technique-specific code be considered?
Use the applicable sibling when the service is specifically cryosurgery or laser surgery: 54056 identifies cryosurgery and 54057 identifies laser surgery.
Can 54055 be reported with excision code 54060?
The codes describe different approaches: 54055 destroys lesions, while 54060 removes them by excision. Documentation should show which approach was performed.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in 54055.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for 54055.
What documentation supports reporting 54055?
Document the penile site, lesion distribution, why treatment was extensive, the destruction method, and the work performed.
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
Show the CMS file lines behind this rate
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