$123.78–$183.08
54055 describes simple penile lesion destruction by electrosurgery. Use 54065 when the documented treatment is extensive.
On this page
CMS RVU26D · Effective 2026-10-01
54065 Penile lesion destruction Medicare reimbursement rates
Report extensive destruction of penile lesions, such as condylomata, when the treatment exceeds the simple lesion-destruction services in this family. Compare 54065 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 54065?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$199.85–$286.96
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $87.11 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 54065 pays more and less
109 payment localities
$199.85 to $286.96
Genital lesion treatment
About 54065: Extensive penile lesion destruction
Report extensive destruction of penile lesions, such as condylomata, when the treatment exceeds the simple lesion-destruction services in this family.
This service covers extensive destruction of penile lesions, including condylomata, molluscum contagiosum, or herpetic lesions. A urologist or other qualified clinician may perform it in an office procedure room or facility using a destructive approach such as electrosurgery, cryosurgery, laser treatment, or curettage. The code reflects extensive treatment rather than a specific instrument or a stated lesion count.
Choose this service when the documented extent of treatment is greater than the simple destruction represented by related penile lesion codes. Record the lesions treated, their location and extent, and the method used. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 54065
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.41 · 36%
- Practice expense (office) RVU4.01 · 60%
- Malpractice RVU0.25 · 4%
1K
Medicare services in 2024 · #2935 by national volume
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.
54065 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$128.10–$189.68
54056 is for simple cryosurgical destruction of penile lesions; 54065 represents extensive destruction.
$179.05–$261.28
54060 is for excision of penile lesions. Choose 54065 when lesions are destroyed rather than removed by excision.
See how rates vary across the country
54065 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$199.85
$267.99
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $267.99 | 1 |
| AL | $202.42 | 1 |
| AR | $199.85 | 1 |
| AZ | $217.43 | 1 |
| CA | $233.14–$286.96 | 29 |
| CO | $230.49 | 1 |
| CT | $236.46 | 1 |
| DC | $251.92 | 1 |
| DE | $220.74 | 1 |
| FL | $221.09–$241.04 | 3 |
| GA | $209.92–$226.85 | 2 |
| GU | $237.62 | 1 |
| HI | $237.62 | 1 |
| IA | $206.36 | 1 |
| ID | $207.67 | 1 |
| IL | $215.83–$234.83 | 4 |
| IN | $208.71 | 1 |
| KS | $205.78 | 1 |
| KY | $207.21 | 1 |
| LA | $207.03–$216.02 | 2 |
| MA | $229.48–$251.15 | 2 |
| MD | $224.51–$251.92 | 3 |
| ME | $208.91–$218.50 | 2 |
| MI | $212.21–$223.82 | 2 |
| MN | $220.79 | 1 |
| MO | $204.08–$216.37 | 3 |
| MS | $201.99 | 1 |
| MT | $222.77 | 1 |
| NC | $210.80 | 1 |
| ND | $217.82 | 1 |
| NE | $207.28 | 1 |
| NH | $227.23 | 1 |
| NJ | $239.14–$249.85 | 2 |
| NM | $213.35 | 1 |
| NV | $221.52 | 1 |
| NY | $213.61–$260.41 | 5 |
| OH | $211.20 | 1 |
| OK | $206.59 | 1 |
| OR | $219.77–$236.80 | 2 |
| PA | $211.34–$231.34 | 2 |
| PR | $224.13 | 1 |
| RI | $227.83 | 1 |
| SC | $211.35 | 1 |
| SD | $217.24 | 1 |
| TN | $206.73 | 1 |
| TX | $210.14–$229.76 | 8 |
| UT | $213.90 | 1 |
| VA | $218.05–$251.92 | 2 |
| VI | $224.13 | 1 |
| VT | $217.32 | 1 |
| WA | $228.93–$255.68 | 2 |
| WI | $211.38 | 1 |
| WV | $208.84 | 1 |
| WY | $220.61 | 1 |
Compare 54065 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $202.42 | Facility $139.29 |
| Alaska* | Office $267.99 | Facility $191.15 |
| Arizona | Office $217.43 | Facility $147.52 |
| Arkansas | Office $199.85 | Facility $137.88 |
| Atlanta | Office $226.85 | Facility $153.55 |
| Austin | Office $229.76 | Facility $153.43 |
| Bakersfield | Office $233.91 | Facility $154.83 |
| Baltimore/Surr. Cntys | Office $235.83 | Facility $158.42 |
| Beaumont | Office $210.14 | Facility $144.48 |
| Brazoria | Office $220.39 | Facility $148.89 |
| Chicago | Office $234.83 | Facility $162.32 |
| Chico | Office $233.14 | Facility $154.06 |
| Colorado | Office $230.49 | Facility $153.73 |
| Connecticut | Office $236.46 | Facility $158.76 |
| Dallas | Office $221.79 | Facility $149.93 |
| Dc + Md/Va Suburbs | Office $251.92 | Facility $166.93 |
| Delaware | Office $220.74 | Facility $149.46 |
| Detroit | Office $223.82 | Facility $154.20 |
| East St. Louis | Office $220.54 | Facility $154.16 |
| El Centro | Office $233.18 | Facility $154.11 |
| Fort Lauderdale | Office $231.27 | Facility $158.19 |
| Fort Worth | Office $220.56 | Facility $149.42 |
| Fresno | Office $233.14 | Facility $154.06 |
| Galveston | Office $221.05 | Facility $149.41 |
| Hanford-Corcoran | Office $233.14 | Facility $154.06 |
| Hawaii, Guam | Office $237.62 | Facility $155.59 |
| Houston | Office $225.63 | Facility $153.99 |
| Idaho | Office $207.67 | Facility $141.29 |
| Indiana | Office $208.71 | Facility $141.84 |
| Iowa | Office $206.36 | Facility $140.35 |
| Kansas | Office $205.78 | Facility $140.56 |
| Kentucky | Office $207.21 | Facility $143.07 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $247.79 | Facility $162.44 |
| Madera | Office $233.14 | Facility $154.06 |
| Manhattan | Office $254.53 | Facility $170.69 |
| Merced | Office $233.14 | Facility $154.06 |
| Metropolitan Boston | Office $251.15 | Facility $165.01 |
| Metropolitan Kansas City | Office $214.42 | Facility $146.68 |
| Metropolitan Philadelphia | Office $231.34 | Facility $156.23 |
| Metropolitan St. Louis | Office $216.37 | Facility $147.69 |
| Miami | Office $241.04 | Facility $165.94 |
| Minnesota | Office $220.79 | Facility $146.55 |
| Mississippi | Office $201.99 | Facility $139.87 |
| Modesto | Office $233.14 | Facility $154.06 |
| Montana** | Office $222.77 | Facility $150.62 |
| Napa | Office $266.34 | Facility $171.25 |
| Nebraska | Office $207.28 | Facility $140.69 |
| Nevada** | Office $221.52 | Facility $149.31 |
| New Hampshire | Office $227.23 | Facility $152.13 |
| New Mexico | Office $213.35 | Facility $147.19 |
| New Orleans | Office $216.02 | Facility $148.13 |
| North Carolina | Office $210.80 | Facility $143.48 |
| North Dakota** | Office $217.82 | Facility $145.68 |
| Northern Nj | Office $249.85 | Facility $166.16 |
| Nyc Suburbs/Long Island | Office $260.41 | Facility $174.62 |
| Ohio | Office $211.20 | Facility $145.33 |
| Oklahoma | Office $206.59 | Facility $142.16 |
| Oxnard-Thousand Oaks-Ventura | Office $246.27 | Facility $160.99 |
| Portland | Office $236.80 | Facility $156.65 |
| Poughkpsie/N Nyc Suburbs | Office $240.88 | Facility $161.88 |
| Puerto Rico | Office $224.13 | Facility $151.19 |
| Queens | Office $256.00 | Facility $170.73 |
| Redding | Office $233.14 | Facility $154.06 |
| Rest Of California | Office $233.14 | Facility $154.06 |
| Rest Of Florida | Office $221.09 | Facility $152.12 |
| Rest Of Georgia | Office $209.92 | Facility $145.57 |
| Rest Of Illinois | Office $215.83 | Facility $149.96 |
| Rest Of Louisiana | Office $207.03 | Facility $143.18 |
| Rest Of Maine | Office $208.91 | Facility $142.54 |
| Rest Of Maryland | Office $224.51 | Facility $151.50 |
| Rest Of Massachusetts | Office $229.48 | Facility $153.51 |
| Rest Of Michigan | Office $212.21 | Facility $146.34 |
| Rest Of Missouri | Office $204.08 | Facility $141.89 |
| Rest Of New Jersey | Office $239.14 | Facility $160.35 |
| Rest Of New York | Office $213.61 | Facility $145.07 |
| Rest Of Oregon | Office $219.77 | Facility $147.91 |
| Rest Of Pennsylvania | Office $211.34 | Facility $145.11 |
| Rest Of Texas | Office $215.14 | Facility $146.68 |
| Rest Of Washington | Office $228.93 | Facility $152.96 |
| Rhode Island | Office $227.83 | Facility $153.30 |
| Riverside-San Bernardino-Ontario | Office $235.86 | Facility $156.79 |
| Sacramento-Roseville-Folsom | Office $243.64 | Facility $159.73 |
| Salinas | Office $242.70 | Facility $159.08 |
| San Diego-Chula Vista-Carlsbad | Office $247.63 | Facility $161.34 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $280.83 | Facility $179.10 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $280.54 | Facility $178.82 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $286.96 | Facility $182.93 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $285.80 | Facility $181.77 |
| San Luis Obispo-Paso Robles | Office $238.90 | Facility $156.72 |
| Santa Cruz-Watsonville | Office $249.40 | Facility $161.74 |
| Santa Maria-Santa Barbara | Office $243.40 | Facility $159.27 |
| Santa Rosa-Petaluma | Office $251.86 | Facility $163.27 |
| Seattle (King Cnty) | Office $255.68 | Facility $167.16 |
| South Carolina | Office $211.35 | Facility $144.69 |
| South Dakota** | Office $217.24 | Facility $145.09 |
| Southern Maine | Office $218.50 | Facility $147.00 |
| Stockton | Office $233.14 | Facility $154.06 |
| Suburban Chicago | Office $233.41 | Facility $159.32 |
| Tennessee | Office $206.73 | Facility $141.15 |
| Utah | Office $213.90 | Facility $146.08 |
| Vallejo | Office $265.93 | Facility $170.84 |
| Vermont | Office $217.32 | Facility $145.90 |
| Virgin Islands | Office $224.13 | Facility $151.19 |
| Virginia | Office $218.05 | Facility $147.13 |
| Visalia | Office $233.14 | Facility $154.06 |
| West Virginia | Office $208.84 | Facility $146.14 |
| Wisconsin | Office $211.38 | Facility $142.26 |
| Wyoming** | Office $220.61 | Facility $148.47 |
| Yuba City | Office $233.14 | Facility $154.06 |
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54065 billing questions
How is this code different from simple penile lesion destruction?
Use 54065 for extensive destruction; simple destruction codes in this family are differentiated by treatment method. Document the extent of treatment rather than relying on the instrument alone.
Can modifier 50 be reported for lesions on both sides?
No. The bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
How does the multiple-procedure reduction work?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50% under the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,24054056,,Cryosurgery penis lesion(s),A,,1.26,2.92,,1.58,,0.13,4.31,2.97,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24154057,,Laser surg penis lesion(s),A,,1.26,2.89,,1.31,,0.16,4.31,2.73,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24254060,,Excision of penis lesion(s),A,,1.93,3.85,,1.50,,0.24,6.02,3.67,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24354065,,Destruction penis lesion(s),A,,2.41,4.01,,1.85,,0.25,6.67,4.51,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24454100,,Biopsy of penis,A,,1.85,4.03,,1.06,,0.20,6.08,3.11,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24554105,,Biopsy of penis,A,,3.45,4.67,,1.96,,0.44,8.56,5.85,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24654110,,Treatment of penis lesion,A,,10.65,5.01,NA,5.01,,1.36,17.02,17.02,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00