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CPT code 54055: Penile lesion destruction, extensive treatment2026 Medicare rate & RVUs in Virginia

Reports extensive destruction of penile lesions, such as condyloma, when treatment goes beyond simple chemical destruction of a limited lesion.

CMS RVU26DEffective Oct 1, 2026One payment locality231 Medicare services in 2024

In Virginia, Medicare pays $136.31 for 54055 in the office and $84.76 when it’s performed in a hospital or facility.

$136.31Office (non-facility)
$84.76Hospital or facility
−2.1%vs the national office rate ($139.28)

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.

We’ll open 54055 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 54055 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Virginia 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. Virginia pays $136.31. The RVUs are the same everywhere; the geographic indexes change the dollars.

54055 in Virginia vs other payment areas
  1. Virginia · this page$136.31
  2. Los Angeles, CA · California$156.56+$20.25
  3. Washington, DC area · District of Columbia$158.72+$22.41
  4. Miami, FL · Florida$150.28+$13.97
  5. Chicago, IL · Illinois$146.09+$9.78
  6. Manhattan, NY · New York$159.83+$23.52
  7. Alaska · Alaska$163.66+$27.35

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

54055 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$125.52$79.64
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

54055 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.

$123.78

$164.95

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
54055 office rate range by state
State / territoryOffice rate rangeLocalities
AK$163.661
AL$125.521
AR$123.781
AZ$135.701
CA$146.81–$183.0829
CO$144.751
CT$148.311
DC$158.721
DE$137.891
FL$137.50–$150.283
GA$130.04–$141.852
GU$150.171
HI$150.171
IA$128.481
ID$129.311
IL$133.75–$146.094
IN$130.031
KS$127.951
KY$128.471
LA$128.29–$134.382
MA$143.96–$158.652
MD$140.43–$158.723
ME$130.01–$136.712
MI$131.72–$139.202
MN$138.711
MO$126.21–$134.793
MS$125.021
MT$139.271
NC$131.311
ND$136.501
NE$129.151
NH$142.551
NJ$150.00–$157.182
NM$132.431
NV$138.591
NY$133.20–$163.645
OH$131.151
OK$128.201
OR$137.52–$149.152
PA$131.33–$144.772
PR$140.241
RI$142.651
SC$131.451
SD$136.181
TN$128.581
TX$130.50–$144.278
UT$133.171
VA$136.31–$158.722
VI$140.241
VT$136.031
WA$143.67–$161.772
WI$132.101
WV$129.001
WY$138.071

See 54055 in every payment locality

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

Office or facility?

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 54055 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.22× 1.0001.2200
Practice expense2.81× 0.9832.7622
Malpractice0.14× 0.7060.0988
Total RVUs4.0811
Conversion factor× 33.4009

Office rate, Virginia$136.31

Office: (1.22 × 1 + 2.81 × 0.983 + 0.14 × 0.706) × $33.4009 = $136.31

Facility: (1.22 × 1 + 1.24 × 0.983 + 0.14 × 0.706) × $33.4009 = $84.76

Open 54055 in the RVU calculator

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

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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%).

When to use modifier 51

Codes related to 54055

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

Codes related to 54055
CodeHow it relatesOffice range, Virginia
Used instead
54050Penile lesion destruction, chemical method, simpleFor simple chemical destruction rather than extensive treatment.$142.90
54060Penile lesion excision, simple excisionReports excision of penile lesions rather than their destruction.$196.53
Same family
54056Penile lesion destruction, cryosurgeryIdentifies extensive penile lesion destruction by cryosurgery.$141.02
54057Penile lesion treatment, laser destructionIdentifies extensive penile lesion destruction by laser surgery.$140.75

How 54055 has changed in Virginia

54055 · Office / nonfacility

$136.31

Effective 2026-10-01

The base rate is $2.69 higher than on 2025-10-01, moving from $133.62 to $136.31 (2.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $133.62changed to$136.31

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.19changed to$133.62

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.77 changed to 2.81

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $133.97changed to$136.19

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $137.70changed to$133.97

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $137.89changed to$137.70

    • 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
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $136.18changed to$137.89

    • 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.

  7. January 1, 2021

    RVU21A

    $128.39changed to$136.18

    • 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
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $124.20changed to$128.39

    • 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
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $122.29changed to$124.20

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.03 changed to 2.08

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $119.83changed to$122.29

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.98 changed to 2.03
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $118.46changed to$119.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.96 changed to 1.98
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $119.30changed to$118.46

    • 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.

  13. July 1, 2015

    RVU15C

    $118.70changed to$119.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $115.10changed to$118.70

    • 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
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $117.15changed to$115.10

    • 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
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $117.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$136.31$84.76RVU26D
2026-07-01$136.31$84.76RVU26C
2026-04-01$136.31$84.76RVU26B
2026-01-01$136.31$84.76RVU26A
2025-10-01$133.62$93.51RVU25D
2025-07-01$133.62$93.51RVU25C
2025-04-01$133.62$93.51RVU25B
2025-01-01$133.62$93.51RVU25A
2024-10-01$136.19$94.59RVU24D
2024-07-01$136.19$94.59RVU24C
2024-04-01$136.19$94.59RVU24B
2024-03-09$136.19$94.59RVU24AR
2024-01-01$133.97$93.05RVU24A
2023-10-01$137.70$95.43RVU23D
2023-07-01$137.70$95.43RVU23C
2023-04-01$137.70$95.43RVU23B
2023-01-01$137.70$95.43RVU23A
2022-10-01$137.89$94.50RVU22D
2022-07-01$137.89$94.50RVU22C
2022-04-01$137.89$94.50RVU22B
2022-01-01$137.89$94.50RVU22A
2021-10-01$136.18$95.56RVU21D
2021-07-01$136.18$95.56RVU21C
2021-04-01$136.18$95.56RVU21B
2021-01-01$136.18$95.56RVU21A
2020-10-01$128.39$95.49RVU20D
2020-07-01$128.39$95.49RVU20C
2020-04-01$128.39$95.49RVU20B
2020-01-01$128.39$95.49RVU20A
2019-10-01$124.20$95.77RVU19D
2019-07-01$124.20$95.77RVU19C
2019-04-01$124.20$95.77RVU19B
2019-01-01$124.20$95.77RVU19A
2018-10-01$122.29$95.31RVU18D
2018-07-01$122.29$95.31RVU18C
2018-04-01$122.29$95.31RVU18B
2018-01-01$122.29$95.31RVU18AR1
2017-10-01$119.83$94.38RVU17D
2017-07-01$119.83$94.38RVU17C
2017-04-01$119.83$94.38RVU17B
2017-01-01$119.83$94.38RVU17A
2016-10-01$118.46$93.12RVU16D
2016-07-01$118.46$93.12RVU16C
2016-04-01$118.46$93.12RVU16B
2016-01-01$118.46$93.12RVU16A
2015-10-01$119.30$93.86RVU15D
2015-07-01$119.30$93.86RVU15C
2015-04-01$118.70$93.40RVU15B
2015-01-01$118.70$93.40RVU15A
2014-10-01$115.10$90.88RVU14D
2014-07-01$115.10$90.88RVU14C
2014-04-01$115.10$90.88RVU14B
2014-01-01$115.10$90.88RVU14A
2013-10-01$117.15$90.89RVU13D
2013-07-01$117.15$90.89RVU13C
2013-04-01$117.15$90.89RVU13B
2013-01-01$117.15$90.89RVU13AR

Price 54055 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 54055PPRRVU2026_Oct_nonQPP.csv, line 6,239 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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