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Billing code 54112: Penile plaque surgeryMedicare rate & RVUs

Reports surgical treatment of Peyronie’s penile plaque when excision and graft reconstruction are required to address deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities68 Medicare services in 2024

Medicare pays $843.37 for 54112 nationally in a facility.

Medicare rate · 54112

Penile plaque surgery

Work RVUs
16.56
Total RVUs
25.25
Global days
090

National rate · 2026

$843.37

Facility setting, before claim adjustments.

See every locality for 54112 →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.

On this page 10 sections
  1. Medicare rate
  2. What 54112 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 54112 covers

A urologist typically performs this operation for Peyronie’s disease when a penile plaque causes deformity and treatment requires plaque excision with graft reconstruction. The service involves operative correction of the affected penile tissue, rather than a biopsy or removal of a superficial lesion such as a wart. It is generally performed in an operating room, with the operative report identifying the plaque, the reconstruction performed, and the graft used.

Report the code when the documented procedure meets the code’s graft-requiring plaque-treatment criteria. The 90-day global period 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; 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 54112 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

54112 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$785.11
Alaska*Unavailable$1,102.23
ArizonaUnavailable$826.34
ArkansasUnavailable$777.97
AtlantaUnavailable$862.84
AustinUnavailable$849.08
BakersfieldUnavailable$847.10
Baltimore/Surr. CntysUnavailable$885.08
BeaumontUnavailable$818.60
BrazoriaUnavailable$830.17

54112 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
54112 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 54112 rate is calculated

Each of 54112’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 · 54112

RVUs × geographic indexes × conversion factor

Work16.56

16.56 RVUs× 1.000 GPCI

Practice expense6.56

6.56 RVUs× 1.000 GPCI

Malpractice2.13

2.13 RVUs× 1.000 GPCI

Adjusted RVUs

25.2500

Conversion factor

$33.4009

Medicare rate

$843.37

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

Payment rules and modifiers for 54112

54112 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54112

Penile plaque surgery

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 · 54112

Penile plaque surgery

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

54112 without 51 · national facility

$843.37

Penile plaque surgery

54112-51 · Second procedure: 50%

$421.69

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

54112 compared with similar codes

Compare codes · National

4 codes, side by side

  • 54112

    Penile plaque surgery16.56 wRVU

    Not priced

  • 54111

    Penile lesion surgery14.06 wRVU

    Not priced

  • 54110

    Penile lesion treatment10.65 wRVU

    Not priced

  • 54115

    Penile plaque surgery6.78 wRVU

    $475.96

How to choose

54111Penile lesion surgery
This is a related penile plaque procedure. Compare the full code descriptors and operative documentation to determine which plaque-treatment service was performed.
54110Penile lesion treatment
This code addresses penile lesion treatment; 54112 describes graft-requiring surgery for Peyronie’s plaque.
54115Penile plaque surgery
This code addresses penile lesion treatment, while 54112 is selected for plaque surgery requiring graft reconstruction.

Codes related to 54112

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

Codes related to 54112
CodeHow it relatesNational office range
Same family
54111Penile lesion surgeryRelated penile plaque procedure; select according to the operative service and the code’s full descriptor.No office rate
Used instead
54110Penile lesion treatmentFor treatment of a penile lesion rather than graft-requiring Peyronie’s plaque surgery.No office rate
54115Penile plaque surgeryFor treatment of a penile lesion; distinguish lesion treatment from plaque excision with graft reconstruction.$430.67–$590.30
54100BiopsyBiopsy obtains tissue for diagnosis; it does not represent plaque excision with graft reconstruction.$180.86–$266.27

54112 billing questions

When is this code used instead of a code for penile lesion excision?

Use this code for Peyronie’s plaque surgery that requires graft reconstruction. Codes for penile lesion treatment address lesions such as condyloma rather than plaque-related deformity.

What documentation supports reporting this code?

The operative report should identify the Peyronie’s plaque, describe its excision and the graft reconstruction, and establish why the procedure required grafting.

Can modifier 50 be reported?

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

How are other procedures performed in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery 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

Show the CMS file lines behind this rate
RVUs for 54112PPRRVU2026_Oct_nonQPP.csv, line 6,248 (RVU26D)

Open CMS sourceHow we calculate rates

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