CPT code 54400: Penile prosthesis, semi-rigid implant2026 Medicare rate & RVUs in New Mexico

In New Mexico, Medicare pays $480.42 for 54400 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 54400 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 54400 covers

A urologist places bendable, non-inflatable rods within the penile erectile bodies to provide penile rigidity. This operation is used for erectile dysfunction when a semi-rigid device is selected, including situations in which a patient prefers a simpler implant that does not require an inflation pump. It is generally performed in a surgical setting, with the operative record identifying the device type and documenting placement.

Select this code for initial insertion of a semi-rigid prosthesis, not an inflatable device or an exchange of an existing implant. Documentation should support the indication, the implant type, and the procedure performed. The CMS global period is 90 days, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is 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 Mexico compares for 54400

Across 109 of 109 payment localities, the facility rate for 54400 runs from $445.49 in Arkansas to $626.65 in Alaska. New Mexico pays $480.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

54400 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 54400 in every payment locality

How the 54400 rate is calculated

Each of 54400’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.

Payment rules and modifiers for 54400

54400 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 54400

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 54400 has changed in New Mexico

Price 54400 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

• Abeytas
• Abiquiu
• Acomita Lake
• Adelino
• Agua Fria
• Alamillo
• Alamo
• Alamogordo

Browse all communities in New Mexico

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

Open CMS sourceHow we calculate rates