$107.63–$158.62
Use 54205 when the plaque is surgically exposed before injection; 54200 represents plaque injection without surgical exposure.
On this page
CMS RVU26D · Effective 2026-10-01
54205 Plaque injection Medicare reimbursement rates
Reports medication injection into a Peyronie's disease plaque when the urologist surgically exposes the plaque during the procedure. Compare 54205 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 54205?
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
No supported rate
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 54205 pays more and less
Urology procedure
About 54205: Peyronie's plaque injection with exposure
Reports medication injection into a Peyronie's disease plaque when the urologist surgically exposes the plaque during the procedure.
A urologist surgically exposes the fibrous penile plaque associated with Peyronie's disease and injects medication directly into it. This is the operative exposure approach, rather than an injection performed without surgical exposure. The service is generally performed in an operating-room setting by a urologist treating a plaque that causes penile curvature or deformity.
Report this code when the documented procedure includes both surgical exposure of the plaque and injection into it; an injection without exposure is represented by 54200. The operative report should identify the Peyronie's plaque and document its exposure and injection. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Assistant-at-surgery payment may be available; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 54205
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.75 · 60%
- Practice expense (office) RVU4.74 · 32%
- Malpractice RVU1.13 · 8%
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.
54205 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$85.22–$119.38
54235 is a therapeutic injection into the corpora cavernosa, not an injection into a surgically exposed Peyronie's plaque.
See how rates vary across the country
54205 · 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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 54205 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 Unavailable | Facility $452.15 |
| Alaska* | Office Unavailable | Facility $627.79 |
| Arizona | Office Unavailable | Facility $477.98 |
| Arkansas | Office Unavailable | Facility $447.69 |
| Atlanta | Office Unavailable | Facility $499.32 |
| Austin | Office Unavailable | Facility $493.79 |
| Bakersfield | Office Unavailable | Facility $494.32 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $513.50 |
| Beaumont | Office Unavailable | Facility $471.39 |
| Brazoria | Office Unavailable | Facility $480.93 |
| Chicago | Office Unavailable | Facility $540.04 |
| Chico | Office Unavailable | Facility $490.98 |
| Colorado | Office Unavailable | Facility $493.70 |
| Connecticut | Office Unavailable | Facility $514.28 |
| Dallas | Office Unavailable | Facility $484.96 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $536.55 |
| Delaware | Office Unavailable | Facility $484.07 |
| Detroit | Office Unavailable | Facility $508.67 |
| East St. Louis | Office Unavailable | Facility $513.93 |
| El Centro | Office Unavailable | Facility $491.16 |
| Fort Lauderdale | Office Unavailable | Facility $520.88 |
| Fort Worth | Office Unavailable | Facility $483.87 |
| Fresno | Office Unavailable | Facility $490.98 |
| Galveston | Office Unavailable | Facility $483.06 |
| Hanford-Corcoran | Office Unavailable | Facility $490.98 |
| Hawaii, Guam | Office Unavailable | Facility $494.12 |
| Houston | Office Unavailable | Facility $503.74 |
| Idaho | Office Unavailable | Facility $455.76 |
| Indiana | Office Unavailable | Facility $457.36 |
| Iowa | Office Unavailable | Facility $452.10 |
| Kansas | Office Unavailable | Facility $454.40 |
| Kentucky | Office Unavailable | Facility $467.54 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $516.59 |
| Madera | Office Unavailable | Facility $490.98 |
| Manhattan | Office Unavailable | Facility $554.79 |
| Merced | Office Unavailable | Facility $490.98 |
| Metropolitan Boston | Office Unavailable | Facility $526.87 |
| Metropolitan Kansas City | Office Unavailable | Facility $477.80 |
| Metropolitan Philadelphia | Office Unavailable | Facility $507.36 |
| Metropolitan St. Louis | Office Unavailable | Facility $480.80 |
| Miami | Office Unavailable | Facility $552.52 |
| Minnesota | Office Unavailable | Facility $466.34 |
| Mississippi | Office Unavailable | Facility $456.46 |
| Modesto | Office Unavailable | Facility $490.98 |
| Montana** | Office Unavailable | Facility $488.25 |
| Napa | Office Unavailable | Facility $538.51 |
| Nebraska | Office Unavailable | Facility $452.65 |
| Nevada** | Office Unavailable | Facility $482.18 |
| New Hampshire | Office Unavailable | Facility $490.09 |
| New Mexico | Office Unavailable | Facility $482.77 |
| New Orleans | Office Unavailable | Facility $484.11 |
| North Carolina | Office Unavailable | Facility $464.09 |
| North Dakota** | Office Unavailable | Facility $465.90 |
| Northern Nj | Office Unavailable | Facility $534.63 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $569.29 |
| Ohio | Office Unavailable | Facility $474.85 |
| Oklahoma | Office Unavailable | Facility $462.96 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $511.09 |
| Portland | Office Unavailable | Facility $500.91 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $524.44 |
| Puerto Rico | Office Unavailable | Facility $489.50 |
| Queens | Office Unavailable | Facility $552.52 |
| Redding | Office Unavailable | Facility $490.98 |
| Rest Of California | Office Unavailable | Facility $490.98 |
| Rest Of Florida | Office Unavailable | Facility $500.34 |
| Rest Of Georgia | Office Unavailable | Facility $478.47 |
| Rest Of Illinois | Office Unavailable | Facility $495.80 |
| Rest Of Louisiana | Office Unavailable | Facility $468.53 |
| Rest Of Maine | Office Unavailable | Facility $461.39 |
| Rest Of Maryland | Office Unavailable | Facility $490.05 |
| Rest Of Massachusetts | Office Unavailable | Facility $493.73 |
| Rest Of Michigan | Office Unavailable | Facility $479.42 |
| Rest Of Missouri | Office Unavailable | Facility $465.49 |
| Rest Of New Jersey | Office Unavailable | Facility $518.24 |
| Rest Of New York | Office Unavailable | Facility $469.20 |
| Rest Of Oregon | Office Unavailable | Facility $476.48 |
| Rest Of Pennsylvania | Office Unavailable | Facility $473.26 |
| Rest Of Texas | Office Unavailable | Facility $476.59 |
| Rest Of Washington | Office Unavailable | Facility $491.49 |
| Rhode Island | Office Unavailable | Facility $495.02 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $503.23 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $507.14 |
| Salinas | Office Unavailable | Facility $505.04 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $510.83 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $560.58 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $559.29 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $572.93 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $567.69 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $497.78 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $510.98 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $505.27 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $515.67 |
| Seattle (King Cnty) | Office Unavailable | Facility $531.97 |
| South Carolina | Office Unavailable | Facility $470.63 |
| South Dakota** | Office Unavailable | Facility $463.26 |
| Southern Maine | Office Unavailable | Facility $472.97 |
| Stockton | Office Unavailable | Facility $490.98 |
| Suburban Chicago | Office Unavailable | Facility $523.78 |
| Tennessee | Office Unavailable | Facility $456.44 |
| Utah | Office Unavailable | Facility $474.97 |
| Vallejo | Office Unavailable | Facility $536.66 |
| Vermont | Office Unavailable | Facility $468.09 |
| Virgin Islands | Office Unavailable | Facility $489.50 |
| Virginia | Office Unavailable | Facility $474.53 |
| Visalia | Office Unavailable | Facility $490.98 |
| West Virginia | Office Unavailable | Facility $483.85 |
| Wisconsin | Office Unavailable | Facility $455.55 |
| Wyoming** | Office Unavailable | Facility $478.51 |
| Yuba City | Office Unavailable | Facility $490.98 |
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54205 billing questions
How is 54205 different from 54200?
54205 describes injection into a Peyronie's plaque after surgical exposure. Use 54200 for the plaque injection procedure without surgical exposure.
What documentation supports 54205?
The operative report should identify the Peyronie's plaque and describe its surgical exposure and injection. The record should support that both parts of the service were performed.
Does the 90-day global period include postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this service.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment 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.
6,25854163,,Repair of circumcision,A,,3.24,2.54,NA,2.54,,0.42,6.20,6.20,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25954164,,Frenulotomy of penis,A,,2.75,2.44,NA,2.44,,0.36,5.55,5.55,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26054200,,Injection px peyronie ds,A,,1.08,2.41,,1.28,,0.14,3.63,2.50,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26154205,,Njx px peyronie ds exps plaq,A,,8.75,4.74,NA,4.74,,1.13,14.62,14.62,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26254220,,Irrg crpra cavrnosa priapism,A,,2.36,4.76,,1.09,,0.43,7.55,3.88,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26354230,,Njx corpora cavernosograpy,A,,1.31,1.83,,0.71,,0.17,3.31,2.19,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26454231,,Dynamic cavernosometry,A,,1.99,2.22,,0.90,,0.25,4.46,3.14,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00