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CPT code 54416: Penile prosthesis, semi-rigid replacement2026 Medicare rate & RVUs

Urologists report this service when they remove and replace a non-inflatable, semi-rigid penile prosthesis during the same operative session.

CMS RVU26DEffective Oct 1, 2026109 payment localities120 Medicare services in 2024

Medicare pays $654.99 for 54416 nationally in a facility.

Medicare rate · 54416

Penile prosthesis, semi-rigid replacement

Office or facility?

Work RVUs
11.78
Total RVUs
19.61
Global days
090

National rate · 2026

$654.99

Facility setting, before claim adjustments.

See every locality for 54416 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 54416 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 54416 covers

A urologist removes an existing semi-rigid penile implant and places a replacement during the same operation. These devices use bendable rods rather than an inflatable pump system and are used to treat erectile dysfunction. The procedure is generally performed in a hospital or ambulatory surgery setting when the implanted device needs replacement, such as because of malfunction or another clinical concern.

Report this code for the same-session removal and replacement of a non-inflatable device; the operative report should identify the prosthesis type and document both removal and replacement. Extensive urethral or bladder repair points to the more complex related code, 54417. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. 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. Assistant-at-surgery payment may be available; 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 54416 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

54416 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$606.82
AlaskaUnavailable$842.97
ArizonaUnavailable$641.22
ArkansasUnavailable$600.88
Atlanta, GAUnavailable$669.63
Austin, TXUnavailable$662.33
Bakersfield, CAUnavailable$663.17
Baltimore area, MDUnavailable$688.60
Beaumont, TXUnavailable$632.41
Brazoria, TXUnavailable$645.21

54416 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
54416 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 54416 rate is calculated

Each of 54416’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 · 54416

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.78

11.78 RVUs× 1.000 GPCI

Practice expense6.33

6.33 RVUs× 1.000 GPCI

Malpractice1.50

1.50 RVUs× 1.000 GPCI

Adjusted RVUs

19.6100

Conversion factor

$33.4009

Medicare rate

$654.99

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 54416

54416 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54416

Penile prosthesis, semi-rigid replacement

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 54416

Penile prosthesis, semi-rigid replacement

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

54416 without 51 · national facility

$654.99

Penile prosthesis, semi-rigid replacement

54416-51 · Second procedure: 50%

$327.50

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%).

When to use modifier 51

54416 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 54416

    Penile prosthesis, semi-rigid replacement11.78 wRVU

    Not priced

  • 54415

    Prosthesis removal, self-contained inflatable device8.66 wRVU

    Not priced

  • 54417

    Penile prosthesis, component removal and replacement15.7 wRVU

    Not priced

  • 54410

    Prosthesis replacement, non-inflatable device14.8 wRVU

    Not priced

How to choose

54415Prosthesis removalSelf-contained inflatable device
54415 is removal without replacement. Choose 54416 when a new semi-rigid prosthesis is placed during the same operative session.
54417Penile prosthesisComponent removal and replacement
54417 identifies the more complex semi-rigid replacement involving extensive urethral or bladder repair; 54416 describes replacement without that added complexity.
54410Prosthesis replacementNon-inflatable device
54410 is for removal and replacement of a multi-component inflatable prosthesis. This code is for a non-inflatable, semi-rigid device.

Codes related to 54416

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

Codes related to 54416
CodeHow it relatesNational office range
Used instead
54415Prosthesis removal, self-contained inflatable deviceRemoval of a semi-rigid prosthesis when no replacement is performed.No office rate
54410Prosthesis replacement, non-inflatable deviceSame-session removal and replacement for a multi-component inflatable prosthesis.No office rate
54400Penile prosthesis, semi-rigid implantInitial insertion of a semi-rigid prosthesis, rather than replacement of an existing device.No office rate
Same family
54417Penile prosthesis, component removal and replacementMore complex semi-rigid replacement involving extensive urethral or bladder repair.No office rate

54416 billing questions

How is this different from code 54415?

Use 54416 when the semi-rigid prosthesis is removed and replaced in the same operative session. Code 54415 describes removal without replacement.

Should removal and insertion be billed as separate procedures?

No. This code describes the same-session removal and replacement of the semi-rigid device; document both parts of the operation.

When should code 54417 be considered?

Use 54417 for the more complex semi-rigid prosthesis replacement involving extensive urethral or bladder repair.

Can modifier 50 be used?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

What global-period services are included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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
RVUs for 54416PPRRVU2026_Oct_nonQPP.csv, line 6,300 (RVU26D)

Open CMS sourceHow we calculate rates

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