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CPT code 54130: Radical penectomy2026 Medicare rate & RVUs

Reports radical removal of the penis with bilateral inguinal lymph node dissection, typically for penile cancer requiring resection and nodal treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,068.49 for 54130 nationally in a facility.

Medicare rate · 54130

Radical penectomy

Office or facility?

Work RVUs
21.29
Total RVUs
31.99
Global days
090

National rate · 2026

$1,068.49

Facility setting, before claim adjustments.

See every locality for 54130 →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 54130 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 54130 covers

This major urologic operation removes the penis as part of a radical resection and includes dissection of inguinal lymph nodes on both sides. Urologists typically perform it in an operating room for penile cancer when the operative plan calls for both the primary tumor resection and bilateral inguinal nodal surgery. The included nodal work distinguishes this service from penile amputation without lymphadenectomy and from procedures addressing pelvic nodes.

Report 54130 when the operative documentation supports radical penile resection and bilateral inguinal lymph node dissection. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The code is priced as bilateral, so modifier 50 does not increase payment. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; 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 54130 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

54130 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$995.54
AlaskaUnavailable$1,400.24
ArizonaUnavailable$1,047.07
ArkansasUnavailable$986.62
Atlanta, GAUnavailable$1,093.28
Austin, TXUnavailable$1,074.90
Bakersfield, CAUnavailable$1,071.75
Baltimore area, MDUnavailable$1,120.97
Beaumont, TXUnavailable$1,038.07
Brazoria, TXUnavailable$1,051.66

54130 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
54130 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 54130 rate is calculated

Each of 54130’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 · 54130

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.29

21.29 RVUs× 1.000 GPCI

Practice expense7.96

7.96 RVUs× 1.000 GPCI

Malpractice2.74

2.74 RVUs× 1.000 GPCI

Adjusted RVUs

31.9900

Conversion factor

$33.4009

Medicare rate

$1,068.49

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

Payment rules and modifiers for 54130

54130 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54130

Radical penectomy

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)2Already bilateral by definition: paid once at 100%.
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 · 54130

Radical penectomy

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

54130 without 51 · national facility

$1,068.49

Radical penectomy

54130-51 · Second procedure: 50%

$534.25

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

54130 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 54130

    Radical penectomy21.29 wRVU

    Not priced

  • 54135

    Penectomy27.47 wRVU

    Not priced

  • 54125

    Penectomy14.2 wRVU

    Not priced

  • 54120

    Penile surgery10.73 wRVU

    Not priced

  • 54100

    Biopsy1.85 wRVU

    $203.08

How to choose

54135Penectomy
Choose 54130 for bilateral inguinal lymph node dissection and 54135 for bilateral pelvic lymph node dissection with radical penile resection.
54125Penectomy
54125 describes complete penile amputation without the bilateral inguinal lymphadenectomy included in 54130.
54120Penile surgery
54120 is for partial penile amputation; 54130 represents radical resection with bilateral inguinal node dissection.
54100Biopsy
54100 is a penile biopsy for tissue diagnosis, not radical resection with bilateral inguinal node dissection.

Codes related to 54130

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

Codes related to 54130
CodeHow it relatesNational office range
Same family
54135PenectomyRelated radical penile resection code with bilateral pelvic rather than inguinal lymph node dissection.No office rate
Used instead
54125PenectomyComplete penile amputation without the bilateral inguinal node dissection included in 54130.No office rate
54120Penile surgeryPartial penile amputation when the documented resection is not radical.No office rate

54130 billing questions

How does 54130 differ from 54135?

54130 includes bilateral inguinal lymph node dissection. 54135 is the related radical penile resection code for bilateral pelvic lymph node dissection.

Can the bilateral node dissection be billed separately?

The bilateral inguinal node dissection is part of 54130. The operative report should document the nodal work performed on both sides.

Should modifier 50 be appended?

The code is already priced as bilateral, and modifier 50 does not increase payment.

What postoperative care is included?

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

How are other procedures in the same session paid?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 54130PPRRVU2026_Oct_nonQPP.csv, line 6,252 (RVU26D)

Open CMS sourceHow we calculate rates

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