CPT code 54415: Prosthesis removal, self-contained inflatable device2026 Medicare rate & RVUs

Medicare pays $489.66 for 54415 nationally in a facility.

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

What 54415 covers

A urologist surgically removes the complete self-contained inflatable penile prosthesis, a device in which the inflatable components are integrated rather than connected to a separate reservoir. The procedure is used when the implant must be explanted, such as for malfunction or infection, and no replacement prosthesis is placed during that operative session. It is generally performed in an operating room, not as an office procedure.

Report 54415 when documentation identifies a self-contained inflatable device and confirms removal of all its components without replacement at the same session. If the surgeon replaces the device during that operation, select the applicable removal-and-replacement code instead. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures occur 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 may pay an assistant at surgery; 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.

Where 54415 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

54415 rates by state

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

How the 54415 rate is calculated

Each of 54415’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 54415

54415 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

54415 compared with similar codes

How to choose

54406Penile prosthesis removalMulticomponent inflatable, no replacement

Use 54406 when removing all components of a multi-component inflatable prosthesis without replacement; 54415 is for the self-contained device type.

54416Penile prosthesisSemi-rigid replacement

Use 54416 when a self-contained inflatable prosthesis is removed and replaced during the same operation; 54415 describes removal without same-session replacement.

54410Prosthesis replacementNon-inflatable device

Use 54410 for same-session removal and replacement of a multi-component inflatable prosthesis, rather than removal alone or removal of a self-contained device.

54401Penile prosthesisInflatable, self-contained

Code 54401 covers insertion of a self-contained inflatable prosthesis; 54415 covers removal of that device without replacement.

Codes related to 54415

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

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