CPT code 54065: Penile lesion destruction, extensive treatment2026 Medicare rate & RVUs in North Carolina

Report extensive destruction of penile lesions, such as condylomata, when the treatment exceeds the simple lesion-destruction services in this family.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In North Carolina, Medicare pays $210.80 for 54065 in the office and $143.48 when it’s performed in a hospital or facility.

$210.80Office (non-facility)
$143.48Hospital or facility
−5.4%vs the national office rate ($222.78)

Check a contract rate as a % of Medicare · 54065 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 54065 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 54065 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 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.

How North Carolina compares for 54065

Across 109 of 109 payment localities, the office rate for 54065 runs from $199.85 in Arkansas to $286.96 in San Benito County, CA. North Carolina pays $210.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

54065 in North Carolina vs other payment areas
  1. North Carolina · this page$210.80
  2. Los Angeles, CA · California$247.79+$36.99
  3. Washington, DC area · District of Columbia$251.92+$41.12
  4. Miami, FL · Florida$241.04+$30.24
  5. Chicago, IL · Illinois$234.83+$24.03
  6. Manhattan, NY · New York$254.53+$43.73
  7. Alaska · Alaska$267.99+$57.19

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

Every other payment area

54065 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$202.42$139.29
ArkansasArkansas$199.85$137.88
ArizonaArizona$217.43$147.52
Bakersfield, CACalifornia$233.91$154.83
Chico, CACalifornia$233.14$154.06
El Centro, CACalifornia$233.18$154.11
Fresno, CACalifornia$233.14$154.06
Hanford, CACalifornia$233.14$154.06

54065 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.

$199.85

$267.99

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

View every state and territory as a table
54065 office rate range by state
State / territoryOffice rate rangeLocalities
AK$267.991
AL$202.421
AR$199.851
AZ$217.431
CA$233.14–$286.9629
CO$230.491
CT$236.461
DC$251.921
DE$220.741
FL$221.09–$241.043
GA$209.92–$226.852
GU$237.621
HI$237.621
IA$206.361
ID$207.671
IL$215.83–$234.834
IN$208.711
KS$205.781
KY$207.211
LA$207.03–$216.022
MA$229.48–$251.152
MD$224.51–$251.923
ME$208.91–$218.502
MI$212.21–$223.822
MN$220.791
MO$204.08–$216.373
MS$201.991
MT$222.771
NC$210.801
ND$217.821
NE$207.281
NH$227.231
NJ$239.14–$249.852
NM$213.351
NV$221.521
NY$213.61–$260.415
OH$211.201
OK$206.591
OR$219.77–$236.802
PA$211.34–$231.342
PR$224.131
RI$227.831
SC$211.351
SD$217.241
TN$206.731
TX$210.14–$229.768
UT$213.901
VA$218.05–$251.922
VI$224.131
VT$217.321
WA$228.93–$255.682
WI$211.381
WV$208.841
WY$220.611

See 54065 in every payment locality

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

Office or facility?

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,243

Code
54065
Physician work
2.41
Practice expense
4.01
Malpractice
0.25

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 54065 in North Carolina
ComponentRVULocality factorAdjusted
Physician work2.41× 1.0002.4100
Practice expense4.01× 0.9333.7413
Malpractice0.25× 0.6390.1598
Total RVUs6.3111
Conversion factor× 33.4009

Office rate, North Carolina$210.80

Office: (2.41 × 1 + 4.01 × 0.933 + 0.25 × 0.639) × $33.4009 = $210.80

Facility: (2.41 × 1 + 1.85 × 0.933 + 0.25 × 0.639) × $33.4009 = $143.48

Open 54065 in the RVU calculator

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

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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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%).

When to use modifier 51

How 54065 has changed in North Carolina

54065 · Office / nonfacility

$210.80

Effective 2026-10-01

The base rate is $4.09 higher than on 2025-10-01, moving from $206.71 to $210.80 (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

    $206.71changed to$210.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.47 changed to 2.41
    • Practice expense RVU 4.04 changed to 4.01
    • Malpractice RVU 0.27 changed to 0.25
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $210.96changed to$206.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.99 changed to 4.04
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $207.52changed to$210.96

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $213.07changed to$207.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.91 changed to 3.99
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $215.56changed to$213.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.83 changed to 3.91
    • Malpractice RVU 0.25 changed to 0.26
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $216.38changed to$215.56

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.80 changed to 3.83

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $215.06changed to$216.38

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.54 changed to 3.80
    • Malpractice RVU 0.26 changed to 0.25
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $215.05changed to$215.06

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.51 changed to 3.54
    • Malpractice RVU 0.33 changed to 0.26
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $214.57changed to$215.05

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 0.32 changed to 0.33

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $212.59changed to$214.57

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.45 changed to 3.51
    • Malpractice RVU 0.33 changed to 0.32
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $211.72changed to$212.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.43 changed to 3.45
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $211.60changed to$211.72

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.42 changed to 3.43
    • Malpractice RVU 0.31 changed to 0.33

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $210.55changed to$211.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $209.17changed to$210.55

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.39 changed to 3.42
    • Malpractice RVU 0.30 changed to 0.31
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $209.95changed to$209.17

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.76 changed to 3.39
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $209.95

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$210.80$143.48RVU26D
2026-07-01$210.80$143.48RVU26C
2026-04-01$210.80$143.48RVU26B
2026-01-01$210.80$143.48RVU26A
2025-10-01$206.71$161.48RVU25D
2025-07-01$206.71$161.48RVU25C
2025-04-01$206.71$161.48RVU25B
2025-01-01$206.71$161.48RVU25A
2024-10-01$210.96$163.19RVU24D
2024-07-01$210.96$163.19RVU24C
2024-04-01$210.96$163.19RVU24B
2024-03-09$210.96$163.19RVU24AR
2024-01-01$207.52$160.52RVU24A
2023-10-01$213.07$164.69RVU23D
2023-07-01$213.07$164.69RVU23C
2023-04-01$213.07$164.69RVU23B
2023-01-01$213.07$164.69RVU23A
2022-10-01$215.56$165.46RVU22D
2022-07-01$215.56$165.46RVU22C
2022-04-01$215.56$165.46RVU22B
2022-01-01$215.56$165.46RVU22A
2021-10-01$216.38$165.54RVU21D
2021-07-01$216.38$165.54RVU21C
2021-04-01$216.38$165.54RVU21B
2021-01-01$216.38$165.54RVU21A
2020-10-01$215.06$169.08RVU20D
2020-07-01$215.06$169.08RVU20C
2020-04-01$215.06$169.08RVU20B
2020-01-01$215.06$169.08RVU20A
2019-10-01$215.05$170.09RVU19D
2019-07-01$215.05$170.09RVU19C
2019-04-01$215.05$170.09RVU19B
2019-01-01$215.05$170.09RVU19A
2018-10-01$214.57$169.99RVU18D
2018-07-01$214.57$169.99RVU18C
2018-04-01$214.57$169.99RVU18B
2018-01-01$214.57$169.99RVU18AR1
2017-10-01$212.59$170.15RVU17D
2017-07-01$212.59$170.15RVU17C
2017-04-01$212.59$170.15RVU17B
2017-01-01$212.59$170.15RVU17A
2016-10-01$211.72$169.77RVU16D
2016-07-01$211.72$169.77RVU16C
2016-04-01$211.72$169.77RVU16B
2016-01-01$211.72$169.77RVU16A
2015-10-01$211.60$169.83RVU15D
2015-07-01$211.60$169.83RVU15C
2015-04-01$210.55$168.98RVU15B
2015-01-01$210.55$168.98RVU15A
2014-10-01$209.17$167.90RVU14D
2014-07-01$209.17$167.90RVU14C
2014-04-01$209.17$167.90RVU14B
2014-01-01$209.17$167.90RVU14A
2013-10-01$209.95$166.12RVU13D
2013-07-01$209.95$166.12RVU13C
2013-04-01$209.95$166.12RVU13B
2013-01-01$209.95$166.12RVU13AR

Price 54065 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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
RVUs for 54065PPRRVU2026_Oct_nonQPP.csv, line 6,243 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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