CPT code 54415: Prosthesis removal, self-contained inflatable device2026 Medicare rate & RVUs in Texas
Removal of every component of a self-contained inflatable penile implant without replacement during the same operation, typically for device malfunction or infection.
CMS doesn’t publish an office rate for 54415 in Texas.
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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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $495.37 |
| Beaumont, TX | Unavailable | $472.34 |
| Brazoria, TX | Unavailable | $482.20 |
| Dallas, TX | Unavailable | $486.25 |
| Fort Worth, TX | Unavailable | $485.11 |
| Galveston, TX | Unavailable | $484.34 |
| Houston, TX | Unavailable | $505.02 |
| Rest of Texas | Unavailable | $477.70 |
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.
How the rate is built · 54415
RVUs × geographic indexes × conversion factor
Work8.66
8.66 RVUs× 1.000 GPCI
Practice expense4.87
4.87 RVUs× 1.000 GPCI
Malpractice1.13
1.13 RVUs× 1.000 GPCI
Adjusted RVUs
14.6600
Conversion factor
$33.4009
Medicare rate
$489.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54415
54415 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54415
Prosthesis removal, self-contained inflatable device
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54415
Prosthesis removal, self-contained inflatable device
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54415 without 51 · national facility
$489.66
Prosthesis removal, self-contained inflatable device
54415-51 · Second procedure: 50%
$244.83
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%).
54415 compared with similar codes
Compare codes · National
5 codes, side by side
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.
54415 billing questions
How is 54415 different from removal of a multi-component implant?
Use 54415 for removal of a self-contained inflatable prosthesis. Code 54406 describes removal of a multi-component inflatable prosthesis.
Can 54415 be reported when a new prosthesis is implanted in the same operation?
No. When the surgeon removes and replaces a self-contained inflatable device during the same session, use 54416.
What documentation supports 54415?
Document the prosthesis type, removal of all its components, and that no replacement prosthesis was placed during the same operative session.
Should modifier 50 be added for removal on both sides?
No. The code’s descriptor and anatomy make modifier 50 inappropriate.
How are other procedures in the same operative session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery billing is 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
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