CPT code 54406: Penile prosthesis removal, multicomponent inflatable, no replacement2026 Medicare rate & RVUs in Rhode Island

In Rhode Island, Medicare pays $672.37 for 54406 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 54406 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 54406 covers

This operation removes the complete implanted system of a multicomponent inflatable penile prosthesis, including its cylinders, pump, and reservoir. Urologists typically perform it in a hospital or ambulatory surgery setting when the device must be explanted, such as for infection, erosion, malfunction, or another clinical reason. The defining distinction is that the prosthesis is removed without replacement during the same operative session; removal of only part of the system is not the service described by this code.

Report the code when the operative record supports removal of all components and confirms that no replacement prosthesis was inserted in that session. If all components are removed and replaced during the operation, consider the applicable removal-and-replacement code instead. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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 may be made; co-surgeon payment requires 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 Rhode Island compares for 54406

Across 109 of 109 payment localities, the facility rate for 54406 runs from $610.85 in Arkansas to $861.82 in Alaska. Rhode Island pays $672.37. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

54406 rates by state

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

See 54406 in every payment locality

How the 54406 rate is calculated

Each of 54406’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 54406

54406 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 54406

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

How 54406 has changed in Rhode Island

Price 54406 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

• Ashaway
• Bradford
• Carolina
• Central Falls
• Charlestown
• Chepachet
• Clayville
• Cranston

Browse all communities in Rhode Island

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