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CPT code 54435: Penile repair, fracture repair2026 Medicare rate & RVUs

Repair a penile fracture by surgically exposing and closing the injured erectile tissue, typically after an acute bending injury to an erect penis.

CMS RVU26DEffective Oct 1, 2026109 payment localities40 Medicare services in 2024

Medicare pays $383.78 for 54435 nationally in a facility.

Medicare rate · 54435

Penile repair, fracture repair

Office or facility?

Work RVUs
6.64
Total RVUs
11.49
Global days
090

National rate · 2026

$383.78

Facility setting, before claim adjustments.

See every locality for 54435 →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 54435 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 54435 covers

A urologist uses this code for operative repair of a penile fracture, usually a tear in the tunica albuginea after forceful bending of an erect penis. The procedure generally involves surgical exploration, management of the associated hematoma, and closure of the tunical defect. It is typically performed in an operating room, often in a hospital or ambulatory surgical setting. The operative report should identify the fracture and describe the repair performed.

Report this code for fracture repair, not for surgery to correct penile curvature or repair a different penile injury. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this repair. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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 54435 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

54435 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$354.65
AlaskaUnavailable$490.43
ArizonaUnavailable$375.51
ArkansasUnavailable$351.05
Atlanta, GAUnavailable$392.35
Austin, TXUnavailable$388.67
Bakersfield, CAUnavailable$389.55
Baltimore area, MDUnavailable$403.86
Beaumont, TXUnavailable$369.74
Brazoria, TXUnavailable$378.03

54435 rates by state

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

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Explore a state

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
54435 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 54435 rate is calculated

Each of 54435’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 · 54435

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.64

6.64 RVUs× 1.000 GPCI

Practice expense3.99

3.99 RVUs× 1.000 GPCI

Malpractice0.86

0.86 RVUs× 1.000 GPCI

Adjusted RVUs

11.4900

Conversion factor

$33.4009

Medicare rate

$383.78

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

Payment rules and modifiers for 54435

54435 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54435

Penile repair, fracture repair

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 54435

Penile repair, fracture repair

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

54435 without 51 · national facility

$383.78

Penile repair, fracture repair

54435-51 · Second procedure: 50%

$191.89

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

54435 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 54435

    Penile repair, fracture repair6.64 wRVU

    Not priced

  • 54440

    Penile repair0 wRVU

    Not priced

  • 54430

    Penile reconstruction, peyronie disease, with graft10.78 wRVU

    Not priced

  • 54408

    Prosthesis repair, multi-component device13.56 wRVU

    Not priced

How to choose

54440Penile repair
Choose 54435 for a penile fracture. Code 54440 is for repair of a penile injury other than a fracture.
54430Penile reconstructionPeyronie disease, with graft
Code 54430 addresses surgical correction of penile angulation, such as with Peyronie's disease; 54435 repairs a traumatic fracture.
54408Prosthesis repairMulti-component device
Code 54408 repairs components of an inflatable penile prosthesis. Code 54435 repairs fractured penile tissue, not implant hardware.

Codes related to 54435

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

Codes related to 54435
CodeHow it relatesNational office range
Same family
54440Penile repairPenile injury repair for a nonfracture injury.No office rate
54430Penile reconstruction, peyronie disease, with graftPenile surgery to correct angulation rather than repair a traumatic fracture.No office rate
54420Penile reconstruction, for injuryCorpora cavernosa surgery for priapism, a different penile condition.No office rate

54435 billing questions

How is this code distinguished from 54440?

Use 54435 for repair of a penile fracture. Code 54440 is for repair of a penile injury that is not a fracture.

Is this code used for Peyronie's disease surgery?

No. Code 54435 describes repair of a fracture, while 54430 is used for penile surgery to correct angulation associated with conditions such as Peyronie's disease.

Can a separate penile prosthesis repair be reported?

A repair of prosthesis components is a different service, represented by code 54408. The operative documentation must support that implant-component repair was performed in addition to fracture repair.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. The operative report should document the fracture and its repair.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this repair. Medicare does not pay an assistant at surgery for code 54435.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Co-surgeons and team surgery are not permitted for this code.

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 54435PPRRVU2026_Oct_nonQPP.csv, line 6,304 (RVU26D)

Open CMS sourceHow we calculate rates

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