CPT code 54065: Penile lesion destruction, extensive treatment2026 Medicare rate & RVUs in Missouri
Report extensive destruction of penile lesions, such as condylomata, when the treatment exceeds the simple lesion-destruction services in this family.
Medicare pays $204.08–$216.37 for 54065 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 54065 covers
This service covers extensive destruction of penile lesions, including condylomata, molluscum contagiosum, or herpetic lesions. A urologist or other qualified clinician may perform it in an office procedure room or facility using a destructive approach such as electrosurgery, cryosurgery, laser treatment, or curettage. The code reflects extensive treatment rather than a specific instrument or a stated lesion count.
Choose this service when the documented extent of treatment is greater than the simple destruction represented by related penile lesion codes. Record the lesions treated, their location and extent, and the method used. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 54065 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$204.08 to $216.37
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $214.42 | $146.68 |
| Metropolitan St. Louis, MO | $216.37 | $147.69 |
| Rest of Missouri | $204.08 | $141.89 |
How the 54065 rate is calculated
Each of 54065’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 · 54065
RVUs × geographic indexes × conversion factor
Work2.41
2.41 RVUs× 1.000 GPCI
Practice expense4.01
4.01 RVUs× 1.000 GPCI
Malpractice0.25
0.25 RVUs× 1.000 GPCI
Adjusted RVUs
6.6700
Conversion factor
$33.4009
Medicare rate
$222.78
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54065
54065 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54065
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 · 54065
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
54065 without 51 · national office
$222.78
Penile lesion destruction, extensive treatment
54065-51 · Second procedure: 50%
$111.39
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%).
54065 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 54055Penile lesion destructionExtensive treatment
- 54055 describes simple penile lesion destruction by electrosurgery. Use 54065 when the documented treatment is extensive.
- 54056Penile lesion destructionCryosurgery
- 54056 is for simple cryosurgical destruction of penile lesions; 54065 represents extensive destruction.
- 54060Penile lesion excisionSimple excision
- 54060 is for excision of penile lesions. Choose 54065 when lesions are destroyed rather than removed by excision.
54065 billing questions
How is this code different from simple penile lesion destruction?
Use 54065 for extensive destruction; simple destruction codes in this family are differentiated by treatment method. Document the extent of treatment rather than relying on the instrument alone.
Can modifier 50 be reported for lesions on both sides?
No. The bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
How does the multiple-procedure reduction work?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50% under the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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
Show the CMS file lines behind this rate
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