Billing code 54220: Corporal irrigationMedicare rate & RVUs
Reports irrigation of the corpora cavernosa to treat priapism, typically as an acute urologic intervention to clear blood from the corporal spaces.
Medicare pays $252.18 for 54220 nationally in the office and $129.60 in a hospital or facility. Local office rates run $222.79–$324.46.
Medicare rate · 54220
Corporal irrigation
Swap in your local Medicare rate.
- Work RVUs
- 2.36
- Total RVUs
- 7.55
- Global days
- 000
National rate · 2026
$252.18
Office setting, before claim adjustments.
See every locality for 54220 → · 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
What 54220 covers
This service involves irrigating the corpora cavernosa to treat priapism, usually a prolonged erection requiring urgent management. A urologist or other qualified physician may perform it in an emergency department, hospital, or office setting. The procedure may be part of a treatment sequence that also includes corporal aspiration or a separately performed intracavernosal medication injection.
Report 54220 when the documented service is corporal irrigation for priapism; distinguish it from pharmacologic injection alone or surgical drainage. The record should identify the priapism indication and describe the irrigation performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one 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. Assistant-at-surgery payment is restricted, and 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 54220 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$222.79 to $324.46
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $226.07 | $118.81 |
| Alaska* | $295.48 | $164.93 |
| Arizona | $245.18 | $126.40 |
| Arkansas | $222.79 | $117.50 |
| Atlanta | $257.84 | $133.30 |
| Austin | $259.92 | $130.23 |
| Bakersfield | $263.32 | $128.97 |
| Baltimore/Surr. Cntys | $268.45 | $136.92 |
| Beaumont | $236.85 | $125.30 |
| Brazoria | $248.22 | $126.74 |
| Chicago | $272.12 | $148.93 |
| Chico | $262.12 | $127.77 |
| Colorado | $260.15 | $129.73 |
| Connecticut | $269.01 | $136.99 |
| Dallas | $250.21 | $128.12 |
| Dc + Md/Va Suburbs | $286.36 | $141.96 |
| Delaware | $249.21 | $128.10 |
| Detroit | $256.46 | $138.17 |
| East St. Louis | $254.02 | $141.25 |
| El Centro | $262.19 | $127.84 |
| Fort Lauderdale | $265.85 | $141.67 |
| Fort Worth | $248.81 | $127.94 |
| Fresno | $262.12 | $127.77 |
| Galveston | $249.22 | $127.50 |
| Hanford-Corcoran | $262.12 | $127.77 |
| Hawaii, Guam | $267.91 | $128.54 |
| Houston | $257.09 | $135.37 |
| Idaho | $231.89 | $119.11 |
| Indiana | $233.19 | $119.56 |
| Iowa | $230.00 | $117.84 |
| Kansas | $229.79 | $118.98 |
| Kentucky | $233.31 | $124.33 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $279.68 | $134.66 |
| Madera | $262.12 | $127.77 |
| Manhattan | $291.39 | $148.95 |
| Merced | $262.12 | $127.77 |
| Metropolitan Boston | $284.67 | $138.31 |
| Metropolitan Kansas City | $242.15 | $127.04 |
| Metropolitan Philadelphia | $262.89 | $135.28 |
| Metropolitan St. Louis | $244.57 | $127.88 |
| Miami | $280.66 | $153.05 |
| Minnesota | $246.68 | $120.54 |
| Mississippi | $226.33 | $120.79 |
| Modesto | $262.12 | $127.77 |
| Montana** | $252.15 | $129.57 |
| Napa | $300.63 | $139.07 |
| Nebraska | $231.00 | $117.86 |
| Nevada** | $249.94 | $127.23 |
| New Hampshire | $256.90 | $129.29 |
| New Mexico | $241.87 | $129.46 |
| New Orleans | $244.75 | $129.40 |
| North Carolina | $236.34 | $121.97 |
| North Dakota** | $243.65 | $121.06 |
| Northern Nj | $283.56 | $141.36 |
| Nyc Suburbs/Long Island | $299.58 | $153.83 |
| Ohio | $238.46 | $126.54 |
| Oklahoma | $231.96 | $122.50 |
| Oxnard-Thousand Oaks-Ventura | $277.91 | $133.01 |
| Portland | $267.41 | $131.22 |
| Poughkpsie/N Nyc Suburbs | $273.84 | $139.62 |
| Puerto Rico | $253.71 | $129.78 |
| Queens | $292.51 | $147.61 |
| Redding | $262.12 | $127.77 |
| Rest Of California | $262.12 | $127.77 |
| Rest Of Florida | $252.41 | $135.22 |
| Rest Of Georgia | $237.76 | $128.42 |
| Rest Of Illinois | $246.43 | $134.51 |
| Rest Of Louisiana | $233.29 | $124.81 |
| Rest Of Maine | $234.03 | $121.25 |
| Rest Of Maryland | $253.70 | $129.64 |
| Rest Of Massachusetts | $258.95 | $129.87 |
| Rest Of Michigan | $240.20 | $128.28 |
| Rest Of Missouri | $229.86 | $124.20 |
| Rest Of New Jersey | $271.35 | $137.49 |
| Rest Of New York | $239.96 | $123.51 |
| Rest Of Oregon | $247.28 | $125.18 |
| Rest Of Pennsylvania | $238.35 | $125.82 |
| Rest Of Texas | $242.68 | $126.35 |
| Rest Of Washington | $258.20 | $129.12 |
| Rhode Island | $257.37 | $130.74 |
| Riverside-San Bernardino-Ontario | $266.75 | $132.40 |
| Sacramento-Roseville-Folsom | $274.27 | $131.70 |
| Salinas | $273.24 | $131.16 |
| San Diego-Chula Vista-Carlsbad | $279.13 | $132.52 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $317.08 | $144.24 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $316.59 | $143.75 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $324.46 | $147.69 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $322.46 | $145.70 |
| San Luis Obispo-Paso Robles | $268.95 | $129.33 |
| Santa Cruz-Watsonville | $281.35 | $132.41 |
| Santa Maria-Santa Barbara | $274.11 | $131.18 |
| Santa Rosa-Petaluma | $284.13 | $133.60 |
| Seattle (King Cnty) | $289.58 | $139.17 |
| South Carolina | $237.94 | $124.67 |
| South Dakota** | $242.64 | $120.06 |
| Southern Maine | $245.45 | $123.97 |
| Stockton | $262.12 | $127.77 |
| Suburban Chicago | $268.11 | $142.22 |
| Tennessee | $231.06 | $119.63 |
| Utah | $241.17 | $125.95 |
| Vallejo | $299.93 | $138.37 |
| Vermont | $243.49 | $122.14 |
| Virgin Islands | $253.71 | $129.78 |
| Virginia | $245.25 | $124.75 |
| Visalia | $262.12 | $127.77 |
| West Virginia | $237.54 | $131.02 |
| Wisconsin | $235.56 | $118.13 |
| Wyoming** | $248.44 | $125.86 |
| Yuba City | $262.12 | $127.77 |
54220 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$222.79
$295.48
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $295.48 | 1 |
| AL | $226.07 | 1 |
| AR | $222.79 | 1 |
| AZ | $245.18 | 1 |
| CA | $262.12–$324.46 | 29 |
| CO | $260.15 | 1 |
| CT | $269.01 | 1 |
| DC | $286.36 | 1 |
| DE | $249.21 | 1 |
| FL | $252.41–$280.66 | 3 |
| GA | $237.76–$257.84 | 2 |
| GU | $267.91 | 1 |
| HI | $267.91 | 1 |
| IA | $230.00 | 1 |
| ID | $231.89 | 1 |
| IL | $246.43–$272.12 | 4 |
| IN | $233.19 | 1 |
| KS | $229.79 | 1 |
| KY | $233.31 | 1 |
| LA | $233.29–$244.75 | 2 |
| MA | $258.95–$284.67 | 2 |
| MD | $253.70–$286.36 | 3 |
| ME | $234.03–$245.45 | 2 |
| MI | $240.20–$256.46 | 2 |
| MN | $246.68 | 1 |
| MO | $229.86–$244.57 | 3 |
| MS | $226.33 | 1 |
| MT | $252.15 | 1 |
| NC | $236.34 | 1 |
| ND | $243.65 | 1 |
| NE | $231.00 | 1 |
| NH | $256.90 | 1 |
| NJ | $271.35–$283.56 | 2 |
| NM | $241.87 | 1 |
| NV | $249.94 | 1 |
| NY | $239.96–$299.58 | 5 |
| OH | $238.46 | 1 |
| OK | $231.96 | 1 |
| OR | $247.28–$267.41 | 2 |
| PA | $238.35–$262.89 | 2 |
| PR | $253.71 | 1 |
| RI | $257.37 | 1 |
| SC | $237.94 | 1 |
| SD | $242.64 | 1 |
| TN | $231.06 | 1 |
| TX | $236.85–$259.92 | 8 |
| UT | $241.17 | 1 |
| VA | $245.25–$286.36 | 2 |
| VI | $253.71 | 1 |
| VT | $243.49 | 1 |
| WA | $258.20–$289.58 | 2 |
| WI | $235.56 | 1 |
| WV | $237.54 | 1 |
| WY | $248.44 | 1 |
How the 54220 rate is calculated
Each of 54220’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 · 54220
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.36Practice expense 4.76Malpractice 0.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54220
The CMS indicators that decide how 54220 is paid alongside other services.
CMS payment indicators · 54220
Corporal irrigation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54220 without 51 · national office
$252.18
Corporal irrigation
54220-51 · Second procedure: 50%
$126.09
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%).
54220 compared with similar codes
Compare codes
54220 vs 54235 vs 54420 vs 54230: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54235Penile injection
- Use 54220 for corporal irrigation to treat priapism; use 54235 for a separately performed pharmacologic injection into the corpora cavernosa.
- 54420Penile reconstruction
- 54220 describes irrigation for priapism. 54420 describes surgical drainage, which may include irrigation; select based on the procedure performed.
- 54230Cavernosography
- 54230 is an injection procedure for cavernosography, a diagnostic study. 54220 is a therapeutic irrigation procedure for priapism.
54220 billing questions
How is 54220 different from 54235?
54220 represents irrigation of the corpora cavernosa for priapism. 54235 represents injection of a pharmacologic agent into the corpora cavernosa; report it only when that injection is a distinct service.
Is irrigation included in surgical drainage under 54420?
54420 describes surgical drainage of the corpus cavernosum for priapism, with or without irrigation. Choose the code that reflects the procedure actually performed; do not separately characterize irrigation that is part of the surgical drainage service.
Does 54220 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. 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 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
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