CPT code 54231: Cavernosometry, dynamic hemodynamic study2026 Medicare rate & RVUs in California
Dynamic cavernosometry measures penile blood-flow and pressure response during a pharmacologically induced erection to evaluate suspected vascular causes of erectile dysfunction.
Medicare pays $153.34–$185.18 for 54231 in the office in California, from Chico, CA to San Benito County, CA. 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 54231 covers
Dynamic cavernosometry is an invasive physiologic study used mainly by urologists to assess penile blood flow and pressure in men with erectile dysfunction when a vascular cause, such as impaired venous occlusion, is suspected. After medication induces an erection, the clinician infuses fluid into the corpora cavernosa and records pressure and flow measurements. The study may be performed in a urology office or facility setting.
Report 54231 when the clinician performs and documents the dynamic pressure-and-flow assessment, rather than an injection or imaging study alone. The record should support the indication, pharmacologic response, measurements, and clinical interpretation. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one 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.
Where 54231 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$153.34 to $185.18
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $154.08 | $105.76 |
| Chico, CA | $153.34 | $105.02 |
| El Centro, CA | $153.38 | $105.06 |
| Fresno, CA | $153.34 | $105.02 |
| Hanford, CA | $153.34 | $105.02 |
| Los Angeles, CA | $162.46 | $110.30 |
| Madera, CA | $153.34 | $105.02 |
| Marin County, CA | $181.17 | $119.00 |
| Merced, CA | $153.34 | $105.02 |
| Modesto, CA | $153.34 | $105.02 |
| Napa, CA | $172.63 | $114.52 |
| Oxnard, CA | $161.18 | $109.06 |
| Redding, CA | $153.34 | $105.02 |
| Rest of California | $153.34 | $105.02 |
| Riverside, CA | $156.06 | $107.73 |
| Sacramento, CA | $159.57 | $108.30 |
| Salinas, CA | $158.94 | $107.84 |
| San Benito County, CA | $185.18 | $121.60 |
| San Diego, CA | $161.67 | $108.94 |
| San Francisco, CA | $180.88 | $118.72 |
| San Luis Obispo, CA | $156.53 | $106.31 |
| Santa Clara County, CA | $184.02 | $120.44 |
| Santa Cruz, CA | $162.43 | $108.86 |
| Santa Maria, CA | $159.26 | $107.86 |
| Santa Rosa, CA | $163.99 | $109.85 |
| Stockton, CA | $153.34 | $105.02 |
| Vallejo, CA | $172.22 | $114.11 |
| Visalia, CA | $153.34 | $105.02 |
| Yuba City, CA | $153.34 | $105.02 |
How the 54231 rate is calculated
Each of 54231’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 · 54231
RVUs × geographic indexes × conversion factor
Work1.99
1.99 RVUs× 1.000 GPCI
Practice expense2.22
2.22 RVUs× 1.000 GPCI
Malpractice0.25
0.25 RVUs× 1.000 GPCI
Adjusted RVUs
4.4600
Conversion factor
$33.4009
Medicare rate
$148.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54231
The CMS indicators that decide how 54231 is paid alongside other services.
CMS payment indicators · 54231
Cavernosometry, dynamic hemodynamic study
| 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
54231 without 51 · national office
$148.97
Cavernosometry, dynamic hemodynamic study
54231-51 · Second procedure: 50%
$74.49
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%).
54231 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 54230CavernosographyContrast injection
- 54230 is the contrast-imaging procedure for cavernosography. Use 54231 for dynamic pressure and flow measurements; both may be performed during the same diagnostic evaluation.
- 54235Penile injectionPharmacologic agent
- 54235 describes injection of a therapeutic agent into the corpora cavernosa. It does not represent the dynamic pressure-and-flow assessment reported with 54231.
- 54240Penile plethysmographyStimulus-response measurement
- 54240 is penile plethysmography, a separate method of evaluating erectile response. Choose 54231 when the clinician performs invasive cavernosal pressure and flow measurements.
- 54250Nocturnal erection testingTumescence and rigidity
- 54250 evaluates nocturnal penile tumescence and rigidity. It is distinct from the induced, invasive hemodynamic study reported with 54231.
54231 billing questions
How is 54231 different from cavernosography?
54231 reports dynamic pressure and flow measurements during a pharmacologically induced erection. Cavernosography uses contrast imaging to show penile venous anatomy and may be performed with cavernosometry.
Does the pharmacologic injection alone support 54231?
No. The service involves a dynamic hemodynamic assessment, not simply injecting an agent into the corpora cavernosa.
What documentation supports reporting this code?
Document the clinical reason for the study, the pharmacologic response, the pressure and flow measurements, and the clinician’s interpretation of the findings.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor and anatomy.
How does the multiple-procedure reduction affect payment?
When 54231 is performed with other procedures in the same session, the highest-valued procedure is paid in full and the other procedure or procedures are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and 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
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