CPT code 54200: Plaque injection, peyronie's disease2026 Medicare rate & RVUs in New Hampshire

A urologist injects medication into a penile plaque to treat Peyronie's disease, rather than injecting the corpora cavernosa for diagnostic testing.

CMS RVU26DEffective Oct 1, 2026One payment locality8.8K Medicare services in 2024

In New Hampshire, Medicare pays $123.96 for 54200 in the office and $84.67 when it’s performed in a hospital or facility.

$123.96Office (non-facility)
$84.67Hospital or facility
+2.2%vs the national office rate ($121.25)

Check a contract rate as a % of Medicare · 54200 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 54200 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Hampshire
  2. What 54200 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 54200 covers

A urologist uses this code for a therapeutic injection directed into the fibrous penile plaque associated with Peyronie's disease. The service is commonly performed in an office or other outpatient setting for a patient with penile curvature or deformity from plaque. The injection targets the plaque; it is distinct from medication injected into the corpora cavernosa to assess erectile response. When a separately reportable drug is supplied, its billing is distinct from the injection procedure.

Report the service when the record supports treatment of Peyronie's plaque and documents the injection performed. The code has a 10-day global period, so related postoperative visits during that period are included. If 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 for this code. Medicare does not pay an assistant at surgery, and 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 New Hampshire compares for 54200

Across 109 of 109 payment localities, the office rate for 54200 runs from $107.63 in Arkansas to $158.62 in San Benito County, CA. New Hampshire pays $123.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

54200 in New Hampshire vs other payment areas
  1. New Hampshire · this page$123.96
  2. Los Angeles, CA · California$135.88+$11.92
  3. Washington, DC area · District of Columbia$138.05+$14.09
  4. Miami, FL · Florida$131.70+$7.74
  5. Chicago, IL · Illinois$127.96+$4.00
  6. Manhattan, NY · New York$139.33+$15.37
  7. Alaska · Alaska$142.41+$18.45

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

Every other payment area

54200 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$109.15$76.13
ArkansasArkansas$107.63$75.21
ArizonaArizona$118.08$81.50
Bakersfield, CACalifornia$127.83$86.46
Chico, CACalifornia$127.42$86.05
El Centro, CACalifornia$127.44$86.07
Fresno, CACalifornia$127.42$86.05
Hanford, CACalifornia$127.42$86.05

54200 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.

$107.63

$143.02

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

View every state and territory as a table
54200 office rate range by state
State / territoryOffice rate rangeLocalities
AK$142.411
AL$109.151
AR$107.631
AZ$118.081
CA$127.42–$158.6229
CO$125.811
CT$129.151
DC$138.051
DE$119.991
FL$120.06–$131.703
GA$113.45–$123.582
GU$130.301
HI$130.301
IA$111.581
ID$112.341
IL$116.87–$127.964
IN$112.971
KS$111.201
KY$111.911
LA$111.79–$117.132
MA$125.14–$137.832
MD$122.19–$138.053
ME$113.04–$118.802
MI$114.85–$121.642
MN$120.291
MO$110.02–$117.393
MS$108.841
MT$121.241
NC$114.161
ND$118.471
NE$112.141
NH$123.961
NJ$130.55–$136.722
NM$115.501
NV$120.541
NY$115.83–$142.785
OH$114.281
OK$111.591
OR$119.53–$129.562
PA$114.39–$126.102
PR$122.061
RI$124.081
SC$114.431
SD$118.141
TN$111.761
TX$113.67–$125.458
UT$115.941
VA$118.50–$138.052
VI$122.061
VT$118.131
WA$124.86–$140.472
WI$114.631
WV$112.721
WY$120.031

See 54200 in every payment locality

How the 54200 rate is calculated

Each of 54200’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 · 54200

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.08

1.08 RVUs× 1.000 GPCI

Practice expense2.41

2.41 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

3.6300

Conversion factor

$33.4009

Medicare rate

$121.25

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

The exact New Hampshire inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,260

Code
54200
Physician work
1.08
Practice expense
2.41
Malpractice
0.14

GPCI2026.csv

74

Locality
New Hampshire
Physician work
1.000
Practice expense
1.041
Malpractice
0.875
Office calculation for 54200 in New Hampshire
ComponentRVULocality factorAdjusted
Physician work1.08× 1.0001.0800
Practice expense2.41× 1.0412.5088
Malpractice0.14× 0.8750.1225
Total RVUs3.7113
Conversion factor× 33.4009

Office rate, New Hampshire$123.96

Office: (1.08 × 1 + 2.41 × 1.041 + 0.14 × 0.875) × $33.4009 = $123.96

Facility: (1.08 × 1 + 1.28 × 1.041 + 0.14 × 0.875) × $33.4009 = $84.67

Open 54200 in the RVU calculator

Payment rules and modifiers for 54200

54200 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54200

Plaque injection, peyronie's disease

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 · 54200

Plaque injection, peyronie's disease

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

54200 without 51 · national office

$121.25

Plaque injection, peyronie's disease

54200-51 · Second procedure: 50%

$60.63

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 54200 has changed in New Hampshire

54200 · Office / nonfacility

$123.96

Effective 2026-10-01

The base rate is $7.11 higher than on 2025-10-01, moving from $116.85 to $123.96 (6.1%).

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

    $116.85changed to$123.96

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.11 changed to 1.08
    • Practice expense RVU 2.29 changed to 2.41
    • Malpractice RVU 0.15 changed to 0.14
    • Practice expense GPCI 1.034 changed to 1.041
    • Malpractice GPCI 0.898 changed to 0.875

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $119.61changed to$116.85

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.28 changed to 2.29
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $117.66changed to$119.61

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $119.50changed to$117.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.21 changed to 2.28
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 0.907 changed to 0.898
  5. January 1, 2023

    RVU23A

    $120.17changed to$119.50

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.17 changed to 2.21
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 1.038 changed to 1.036
    • Malpractice GPCI 0.917 changed to 0.907

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $119.31changed to$120.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.11 changed to 2.17
    • Malpractice RVU 0.13 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $117.28changed to$119.31

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.94 changed to 2.11
    • Malpractice RVU 0.12 changed to 0.13
    • Practice expense GPCI 1.042 changed to 1.038
    • Malpractice GPCI 0.984 changed to 0.917

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $116.10changed to$117.28

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.90 changed to 1.94
    • Practice expense GPCI 1.045 changed to 1.042
    • Malpractice GPCI 1.050 changed to 0.984

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $115.60changed to$116.10

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.89 changed to 1.90

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $113.07changed to$115.60

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.83 changed to 1.89
    • Practice expense GPCI 1.052 changed to 1.045
    • Malpractice GPCI 0.962 changed to 1.050

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $112.06changed to$113.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.81 changed to 1.83
    • Practice expense GPCI 1.058 changed to 1.052
    • Malpractice GPCI 0.873 changed to 0.962

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $112.46changed to$112.06

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $111.90changed to$112.46

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $109.89changed to$111.90

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.78 changed to 1.81
    • Malpractice RVU 0.10 changed to 0.12
    • Practice expense GPCI 1.051 changed to 1.058
    • Malpractice GPCI 0.867 changed to 0.873

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$109.89

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$123.96$84.67RVU26D
2026-07-01$123.96$84.67RVU26C
2026-04-01$123.96$84.67RVU26B
2026-01-01$123.96$84.67RVU26A
2025-10-01$116.85$87.76RVU25D
2025-07-01$116.85$87.76RVU25C
2025-04-01$116.85$87.76RVU25B
2025-01-01$116.85$87.76RVU25A
2024-10-01$119.61$88.98RVU24D
2024-07-01$119.61$88.98RVU24C
2024-04-01$119.61$88.98RVU24B
2024-03-09$119.61$88.98RVU24AR
2024-01-01$117.66$87.52RVU24A
2023-10-01$119.50$88.26RVU23D
2023-07-01$119.50$88.26RVU23C
2023-04-01$119.50$88.26RVU23B
2023-01-01$119.50$88.26RVU23A
2022-10-01$120.17$88.20RVU22D
2022-07-01$120.17$88.20RVU22C
2022-04-01$120.17$88.20RVU22B
2022-01-01$120.17$88.20RVU22A
2021-10-01$119.31$88.16RVU21D
2021-07-01$119.31$88.16RVU21C
2021-04-01$119.31$88.16RVU21B
2021-01-01$119.31$88.16RVU21A
2020-10-01$117.28$88.70RVU20D
2020-07-01$117.28$88.70RVU20C
2020-04-01$117.28$88.70RVU20B
2020-01-01$117.28$88.70RVU20A
2019-10-01$116.10$89.36RVU19D
2019-07-01$116.10$89.36RVU19C
2019-04-01$116.10$89.36RVU19B
2019-01-01$116.10$89.36RVU19A
2018-10-01$115.60$89.64RVU18D
2018-07-01$115.60$89.64RVU18C
2018-04-01$115.60$89.64RVU18B
2018-01-01$115.60$89.64RVU18AR1
2017-10-01$113.07$88.53RVU17D
2017-07-01$113.07$88.53RVU17C
2017-04-01$113.07$88.53RVU17B
2017-01-01$113.07$88.53RVU17A
2016-10-01$112.06$87.81RVU16D
2016-07-01$112.06$87.81RVU16C
2016-04-01$112.06$87.81RVU16B
2016-01-01$112.06$87.81RVU16A
2015-10-01$112.46$88.13RVU15D
2015-07-01$112.46$88.13RVU15C
2015-04-01$111.90$87.69RVU15B
2015-01-01$111.90$87.69RVU15A
2014-10-01$109.89$86.54RVU14D
2014-07-01$109.89$86.54RVU14C
2014-04-01$109.89$86.54RVU14B
2014-01-01$109.89$86.54RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 54200 for an earlier date of service

Where the New Hampshire rate applies

New Hampshire is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in New Hampshire. Some span more than one payment area; confirm with the service ZIP.

  • Alton
  • Amherst
  • Antrim
  • Ashland
  • Bartlett
  • Belmont
  • Bennington
  • Berlin

Browse all communities in New Hampshire

54200 billing questions

How does 54200 differ from 54205?

54200 describes injection treatment without surgical exposure of the plaque. 54205 is the related code for injection performed with surgical exposure of the plaque.

Can the medication be billed separately?

The injection procedure and a separately reportable drug are distinct items. Report a drug code only when the drug was supplied and the applicable drug billing requirements are met.

Is modifier 50 appropriate for multiple plaques or both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.

What documentation supports 54200?

Document Peyronie's disease, the plaque treated, the therapeutic injection performed, and the clinical context supporting plaque-directed treatment.

Are related follow-up visits included?

Yes. Related postoperative visits during the 10-day global period are included in the procedure payment.

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 54200PPRRVU2026_Oct_nonQPP.csv, line 6,260 (RVU26D)
Geographic factors for New HampshireGPCI2026.csv, line 74 (RVU26D)

Open CMS sourceHow we calculate rates

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