CPT code 54220: Corporal irrigation, priapism treatment2026 Medicare rate & RVUs in Missouri
Reports irrigation of the corpora cavernosa to treat priapism, typically as an acute urologic intervention to clear blood from the corporal spaces.
Medicare pays $229.86–$244.57 for 54220 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 54220 covers
This service involves irrigating the corpora cavernosa to treat priapism, usually a prolonged erection requiring urgent management. A urologist or other qualified physician may perform it in an emergency department, hospital, or office setting. The procedure may be part of a treatment sequence that also includes corporal aspiration or a separately performed intracavernosal medication injection.
Report 54220 when the documented service is corporal irrigation for priapism; distinguish it from pharmacologic injection alone or surgical drainage. The record should identify the priapism indication and describe the irrigation performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one 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. Assistant-at-surgery payment is restricted, 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.
Where 54220 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
$229.86 to $244.57
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $242.15 | $127.04 |
| Metropolitan St. Louis, MO | $244.57 | $127.88 |
| Rest of Missouri | $229.86 | $124.20 |
How the 54220 rate is calculated
Each of 54220’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 · 54220
RVUs × geographic indexes × conversion factor
Work2.36
2.36 RVUs× 1.000 GPCI
Practice expense4.76
4.76 RVUs× 1.000 GPCI
Malpractice0.43
0.43 RVUs× 1.000 GPCI
Adjusted RVUs
7.5500
Conversion factor
$33.4009
Medicare rate
$252.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54220
The CMS indicators that decide how 54220 is paid alongside other services.
CMS payment indicators · 54220
Corporal irrigation, priapism treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54220 without 51 · national office
$252.18
Corporal irrigation, priapism treatment
54220-51 · Second procedure: 50%
$126.09
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%).
54220 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 54235Penile injectionPharmacologic agent
- Use 54220 for corporal irrigation to treat priapism; use 54235 for a separately performed pharmacologic injection into the corpora cavernosa.
- 54420Penile reconstructionFor injury
- 54220 describes irrigation for priapism. 54420 describes surgical drainage, which may include irrigation; select based on the procedure performed.
- 54230CavernosographyContrast injection
- 54230 is an injection procedure for cavernosography, a diagnostic study. 54220 is a therapeutic irrigation procedure for priapism.
54220 billing questions
How is 54220 different from 54235?
54220 represents irrigation of the corpora cavernosa for priapism. 54235 represents injection of a pharmacologic agent into the corpora cavernosa; report it only when that injection is a distinct service.
Is irrigation included in surgical drainage under 54420?
54420 describes surgical drainage of the corpus cavernosum for priapism, with or without irrigation. Choose the code that reflects the procedure actually performed; do not separately characterize irrigation that is part of the surgical drainage service.
Does 54220 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. 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
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