CPT code 54200: Plaque injection, peyronie's disease2026 Medicare rate & RVUs in Virgin Islands, VI

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 Virgin Islands, VI, Medicare pays $122.06 for 54200 in the office and $83.90 when it’s performed in a hospital or facility.

$122.06Office (non-facility)
$83.90Hospital or facility
+0.7%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 Virgin Islands, VI
  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 Virgin Islands, VI 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. Virgin Islands, VI pays $122.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

54200 in Virgin Islands, VI vs other payment areas
  1. Virgin Islands, VI · this page$122.06
  2. Los Angeles, CA · California$135.88+$13.82
  3. Washington, DC area · District of Columbia$138.05+$15.99
  4. Miami, FL · Florida$131.70+$9.64
  5. Chicago, IL · Illinois$127.96+$5.90
  6. Manhattan, NY · New York$139.33+$17.27
  7. Alaska · Alaska$142.41+$20.35

Other areas in United States Virgin Islands 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 Virgin Islands, VI 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

107

Locality
Virgin Islands, VI
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 54200 in Virgin Islands, VI
ComponentRVULocality factorAdjusted
Physician work1.08× 1.0001.0800
Practice expense2.41× 1.0112.4365
Malpractice0.14× 0.9850.1379
Total RVUs3.6544
Conversion factor× 33.4009

Office rate, Virgin Islands, VI$122.06

Office: (1.08 × 1 + 2.41 × 1.011 + 0.14 × 0.985) × $33.4009 = $122.06

Facility: (1.08 × 1 + 1.28 × 1.011 + 0.14 × 0.985) × $33.4009 = $83.90

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 Virgin Islands, VI

54200 · Office / nonfacility

$122.06

Effective 2026-10-01

The base rate is $6.80 higher than on 2025-10-01, moving from $115.26 to $122.06 (5.9%).

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

    $115.26changed to$122.06

    • 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 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $117.95changed to$115.26

    • 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

    $116.03changed to$117.95

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $117.77changed to$116.03

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.21 changed to 2.28
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $117.25changed to$117.77

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $118.20changed to$117.25

    • 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 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $117.42changed to$118.20

    • 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.

  8. January 1, 2021

    RVU21A

    $114.91changed to$117.42

    • 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
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $113.24changed to$114.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.90 changed to 1.94
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $112.75changed to$113.24

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

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $110.18changed to$112.75

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.83 changed to 1.89
    • Practice expense GPCI 1.006 changed to 1.007
    • Malpractice GPCI 0.993 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $106.24changed to$110.18

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.81 changed to 1.83
    • Practice expense GPCI 0.960 changed to 1.006
    • Malpractice GPCI 0.996 changed to 0.993

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $106.62changed to$106.24

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $106.09changed to$106.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $107.38changed to$106.09

    • 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 1.004 changed to 0.960
    • Malpractice GPCI 1.003 changed to 0.996

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $107.34changed to$107.38

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.94 changed to 1.78
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 1.010 changed to 1.003

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $107.34

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$122.06$83.90RVU26D
2026-07-01$122.06$83.90RVU26C
2026-04-01$122.06$83.90RVU26B
2026-01-01$122.06$83.90RVU26A
2025-10-01$115.26$86.92RVU25D
2025-07-01$115.26$86.92RVU25C
2025-04-01$115.26$86.92RVU25B
2025-01-01$115.26$86.92RVU25A
2024-10-01$117.95$88.12RVU24D
2024-07-01$117.95$88.12RVU24C
2024-04-01$117.95$88.12RVU24B
2024-03-09$117.95$88.12RVU24AR
2024-01-01$116.03$86.68RVU24A
2023-10-01$117.77$87.37RVU23D
2023-07-01$117.25$87.09RVU23C
2023-04-01$117.25$87.09RVU23B
2023-01-01$117.25$87.09RVU23A
2022-10-01$118.20$87.16RVU22D
2022-07-01$118.20$87.16RVU22C
2022-04-01$118.20$87.16RVU22B
2022-01-01$118.20$87.16RVU22A
2021-10-01$117.42$87.17RVU21D
2021-07-01$117.42$87.17RVU21C
2021-04-01$117.42$87.17RVU21B
2021-01-01$117.42$87.17RVU21A
2020-10-01$114.91$87.26RVU20D
2020-07-01$114.91$87.26RVU20C
2020-04-01$114.91$87.26RVU20B
2020-01-01$114.91$87.26RVU20A
2019-10-01$113.24$87.47RVU19D
2019-07-01$113.24$87.47RVU19C
2019-04-01$113.24$87.47RVU19B
2019-01-01$113.24$87.47RVU19A
2018-10-01$112.75$87.74RVU18D
2018-07-01$112.75$87.74RVU18C
2018-04-01$112.75$87.74RVU18B
2018-01-01$112.75$87.74RVU18AR1
2017-10-01$110.18$86.72RVU17D
2017-07-01$110.18$86.72RVU17C
2017-04-01$110.18$86.72RVU17B
2017-01-01$110.18$86.72RVU17A
2016-10-01$106.24$84.24RVU16D
2016-07-01$106.24$84.24RVU16C
2016-04-01$106.24$84.24RVU16B
2016-01-01$106.24$84.24RVU16A
2015-10-01$106.62$84.54RVU15D
2015-07-01$106.62$84.54RVU15C
2015-04-01$106.09$84.12RVU15B
2015-01-01$106.09$84.12RVU15A
2014-10-01$107.38$85.08RVU14D
2014-07-01$107.38$85.08RVU14C
2014-04-01$107.38$85.08RVU14B
2014-01-01$107.38$85.08RVU14A
2013-10-01$107.34$83.47RVU13D
2013-07-01$107.34$83.47RVU13C
2013-04-01$107.34$83.47RVU13B
2013-01-01$107.34$83.47RVU13AR

Price 54200 for an earlier date of service

Where the Virgin Islands, VI rate applies

Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.

  • Charlotte Amalie
  • Charlotte Amalie East
  • Charlotte Amalie West
  • Christiansted
  • Coral Bay
  • Cruz Bay
  • Frederiksted
  • Frederiksted Southeast

Browse all communities in United States Virgin Islands

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 Virgin Islands, VIGPCI2026.csv, line 107 (RVU26D)

Open CMS sourceHow we calculate rates

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