CPT code 54220: Corporal irrigation, priapism treatment2026 Medicare rate & RVUs in Puerto Rico

Reports irrigation of the corpora cavernosa to treat priapism, typically as an acute urologic intervention to clear blood from the corporal spaces.

CMS RVU26DEffective Oct 1, 2026One payment locality553 Medicare services in 2024

In Puerto Rico, Medicare pays $253.71 for 54220 in the office and $129.78 when it’s performed in a hospital or facility.

$253.71Office (non-facility)
$129.78Hospital or facility
+0.6%vs the national office rate ($252.18)

Check a contract rate as a % of Medicare · 54220 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 54220 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 54220 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 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.

How Puerto Rico compares for 54220

Across 109 of 109 payment localities, the office rate for 54220 runs from $222.79 in Arkansas to $324.46 in San Benito County, CA. Puerto Rico pays $253.71. The RVUs are the same everywhere; the geographic indexes change the dollars.

54220 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$253.71
  2. Los Angeles, CA · California$279.68+$25.97
  3. Washington, DC area · District of Columbia$286.36+$32.65
  4. Miami, FL · Florida$280.66+$26.95
  5. Chicago, IL · Illinois$272.12+$18.41
  6. Manhattan, NY · New York$291.39+$37.68
  7. Alaska · Alaska$295.48+$41.77

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

54220 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$226.07$118.81
ArkansasArkansas$222.79$117.50
ArizonaArizona$245.18$126.40
Bakersfield, CACalifornia$263.32$128.97
Chico, CACalifornia$262.12$127.77
El Centro, CACalifornia$262.19$127.84
Fresno, CACalifornia$262.12$127.77
Hanford, CACalifornia$262.12$127.77

54220 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.

$222.79

$295.48

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

View every state and territory as a table
54220 office rate range by state
State / territoryOffice rate rangeLocalities
AK$295.481
AL$226.071
AR$222.791
AZ$245.181
CA$262.12–$324.4629
CO$260.151
CT$269.011
DC$286.361
DE$249.211
FL$252.41–$280.663
GA$237.76–$257.842
GU$267.911
HI$267.911
IA$230.001
ID$231.891
IL$246.43–$272.124
IN$233.191
KS$229.791
KY$233.311
LA$233.29–$244.752
MA$258.95–$284.672
MD$253.70–$286.363
ME$234.03–$245.452
MI$240.20–$256.462
MN$246.681
MO$229.86–$244.573
MS$226.331
MT$252.151
NC$236.341
ND$243.651
NE$231.001
NH$256.901
NJ$271.35–$283.562
NM$241.871
NV$249.941
NY$239.96–$299.585
OH$238.461
OK$231.961
OR$247.28–$267.412
PA$238.35–$262.892
PR$253.711
RI$257.371
SC$237.941
SD$242.641
TN$231.061
TX$236.85–$259.928
UT$241.171
VA$245.25–$286.362
VI$253.711
VT$243.491
WA$258.20–$289.582
WI$235.561
WV$237.541
WY$248.441

See 54220 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,262

Code
54220
Physician work
2.36
Practice expense
4.76
Malpractice
0.43

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 54220 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.36× 1.0002.3600
Practice expense4.76× 1.0114.8124
Malpractice0.43× 0.9850.4235
Total RVUs7.5959
Conversion factor× 33.4009

Office rate, Puerto Rico$253.71

Office: (2.36 × 1 + 4.76 × 1.011 + 0.43 × 0.985) × $33.4009 = $253.71

Facility: (2.36 × 1 + 1.09 × 1.011 + 0.43 × 0.985) × $33.4009 = $129.78

Open 54220 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

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%).

When to use modifier 51

How 54220 has changed in Puerto Rico

54220 · Office / nonfacility

$253.71

Effective 2026-10-01

The base rate is $36.66 higher than on 2025-10-01, moving from $217.05 to $253.71 (16.9%).

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

    $217.05changed to$253.71

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.42 changed to 2.36
    • Practice expense RVU 3.88 changed to 4.76
    • Malpractice RVU 0.39 changed to 0.43
    • 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

    $224.03changed to$217.05

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.89 changed to 3.88
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $220.37changed to$224.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $223.80changed to$220.37

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.79 changed to 3.89
    • Malpractice RVU 0.37 changed to 0.40
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $222.98changed to$223.80

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

    RVU23A

    $226.49changed to$222.98

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.73 changed to 3.79
    • 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

    $226.26changed to$226.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.68 changed to 3.73
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $219.87changed to$226.26

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.30 changed to 3.68
    • Malpractice RVU 0.35 changed to 0.36
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $215.86changed to$219.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.24 changed to 3.30
    • Malpractice RVU 0.31 changed to 0.35
    • 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

    $214.18changed to$215.86

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.22 changed to 3.24
    • Malpractice RVU 0.29 changed to 0.31

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $189.92changed to$214.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.13 changed to 3.22
    • Malpractice RVU 0.30 changed to 0.29
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $167.79changed to$189.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.09 changed to 3.13
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $168.50changed to$167.79

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.31 changed to 0.30

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $167.66changed to$168.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $164.48changed to$167.66

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.04 changed to 3.09
    • Malpractice RVU 0.25 changed to 0.31
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $159.97changed to$164.48

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.27 changed to 3.04
    • Malpractice RVU 0.26 changed to 0.25
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $159.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$253.71$129.78RVU26D
2026-07-01$253.71$129.78RVU26C
2026-04-01$253.71$129.78RVU26B
2026-01-01$253.71$129.78RVU26A
2025-10-01$217.05$130.41RVU25D
2025-07-01$217.05$130.41RVU25C
2025-04-01$217.05$130.41RVU25B
2025-01-01$217.05$130.41RVU25A
2024-10-01$224.03$133.86RVU24D
2024-07-01$224.03$133.86RVU24C
2024-04-01$224.03$133.86RVU24B
2024-03-09$224.03$133.86RVU24AR
2024-01-01$220.37$131.67RVU24A
2023-10-01$223.80$133.63RVU23D
2023-07-01$222.98$133.52RVU23C
2023-04-01$222.98$133.52RVU23B
2023-01-01$222.98$133.52RVU23A
2022-10-01$226.49$135.09RVU22D
2022-07-01$226.49$135.09RVU22C
2022-04-01$226.49$135.09RVU22B
2022-01-01$226.49$135.09RVU22A
2021-10-01$226.26$135.87RVU21D
2021-07-01$226.26$135.87RVU21C
2021-04-01$226.26$135.87RVU21B
2021-01-01$226.26$135.87RVU21A
2020-10-01$219.87$139.47RVU20D
2020-07-01$219.87$139.47RVU20C
2020-04-01$219.87$139.47RVU20B
2020-01-01$219.87$139.47RVU20A
2019-10-01$215.86$139.65RVU19D
2019-07-01$215.86$139.65RVU19C
2019-04-01$215.86$139.65RVU19B
2019-01-01$215.86$139.65RVU19A
2018-10-01$214.18$139.87RVU18D
2018-07-01$214.18$139.87RVU18C
2018-04-01$214.18$139.87RVU18B
2018-01-01$214.18$139.87RVU18AR1
2017-10-01$189.92$129.40RVU17D
2017-07-01$189.92$129.40RVU17C
2017-04-01$189.92$129.40RVU17B
2017-01-01$189.92$129.40RVU17A
2016-10-01$167.79$118.57RVU16D
2016-07-01$167.79$118.57RVU16C
2016-04-01$167.79$118.57RVU16B
2016-01-01$167.79$118.57RVU16A
2015-10-01$168.50$119.10RVU15D
2015-07-01$168.50$119.10RVU15C
2015-04-01$167.66$118.51RVU15B
2015-01-01$167.66$118.51RVU15A
2014-10-01$164.48$117.38RVU14D
2014-07-01$164.48$117.38RVU14C
2014-04-01$164.48$117.38RVU14B
2014-01-01$164.48$117.38RVU14A
2013-10-01$159.97$112.91RVU13D
2013-07-01$159.97$112.91RVU13C
2013-04-01$159.97$112.91RVU13B
2013-01-01$159.97$112.91RVU13AR

Price 54220 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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

Show the CMS file lines behind this rate
RVUs for 54220PPRRVU2026_Oct_nonQPP.csv, line 6,262 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 54220 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 54220 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist