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

In Montana, Medicare pays $654.89 for 54416 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 54416 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 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.

How Montana compares for 54416

Across 109 of 109 payment localities, the facility rate for 54416 runs from $600.88 in Arkansas to $842.97 in Alaska. Montana pays $654.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

54416 rates by state

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

See 54416 in every payment locality

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.

Payment rules and modifiers for 54416

54416 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 54416

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

How 54416 has changed in Montana

Price 54416 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

• Absarokee
• Acton
• Alberton
• Alder
• Alzada
• Amsterdam
• Anaconda-Deer Lodge County
• Antelope

Browse all communities in Montana

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