Billing code 54231: CavernosometryMedicare rate & RVUs
Dynamic cavernosometry measures penile blood-flow and pressure response during a pharmacologically induced erection to evaluate suspected vascular causes of erectile dysfunction.
Medicare pays $148.97 for 54231 nationally in the office and $104.88 in a hospital or facility. Local office rates run $134.46–$185.18.
Medicare rate · 54231
Cavernosometry
- Work RVUs
- 1.99
- Total RVUs
- 4.46
- Global days
- 000
National rate · 2026
$148.97
Office setting, before claim adjustments.
See every locality for 54231 →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 54231 covers
Dynamic cavernosometry is an invasive physiologic study used mainly by urologists to assess penile blood flow and pressure in men with erectile dysfunction when a vascular cause, such as impaired venous occlusion, is suspected. After medication induces an erection, the clinician infuses fluid into the corpora cavernosa and records pressure and flow measurements. The study may be performed in a urology office or facility setting.
Report 54231 when the clinician performs and documents the dynamic pressure-and-flow assessment, rather than an injection or imaging study alone. The record should support the indication, pharmacologic response, measurements, and clinical interpretation. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, 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 54231 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
$134.46 to $185.18
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $136.08 | $97.50 |
| Alaska* | $183.27 | $136.32 |
| Arizona | $145.47 | $102.74 |
| Arkansas | $134.46 | $96.59 |
| Atlanta | $152.03 | $107.24 |
| Austin | $152.45 | $105.80 |
| Bakersfield | $154.08 | $105.76 |
| Baltimore/Surr. Cntys | $157.42 | $110.12 |
| Beaumont | $141.70 | $101.58 |
| Brazoria | $147.00 | $103.30 |
| Chicago | $160.62 | $116.31 |
| Chico | $153.34 | $105.02 |
| Colorado | $152.68 | $105.77 |
| Connecticut | $157.76 | $110.28 |
| Dallas | $148.08 | $104.17 |
| Dc + Md/Va Suburbs | $166.70 | $114.76 |
| Delaware | $147.57 | $104.01 |
| Detroit | $152.10 | $109.55 |
| East St. Louis | $151.50 | $110.94 |
| El Centro | $153.38 | $105.06 |
| Fort Lauderdale | $156.68 | $112.02 |
| Fort Worth | $147.45 | $103.98 |
| Fresno | $153.34 | $105.02 |
| Galveston | $147.54 | $103.76 |
| Hanford-Corcoran | $153.34 | $105.02 |
| Hawaii, Guam | $155.61 | $105.48 |
| Houston | $152.12 | $108.34 |
| Idaho | $138.64 | $98.07 |
| Indiana | $139.26 | $98.39 |
| Iowa | $137.63 | $97.29 |
| Kansas | $137.71 | $97.85 |
| Kentucky | $140.03 | $100.83 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $162.46 | $110.30 |
| Madera | $153.34 | $105.02 |
| Manhattan | $170.13 | $118.90 |
| Merced | $153.34 | $105.02 |
| Metropolitan Boston | $165.16 | $112.52 |
| Metropolitan Kansas City | $144.25 | $102.85 |
| Metropolitan Philadelphia | $154.82 | $108.92 |
| Metropolitan St. Louis | $145.43 | $103.45 |
| Miami | $164.78 | $118.88 |
| Minnesota | $145.24 | $99.87 |
| Mississippi | $136.48 | $98.52 |
| Modesto | $153.34 | $105.02 |
| Montana** | $148.95 | $104.86 |
| Napa | $172.63 | $114.52 |
| Nebraska | $138.06 | $97.37 |
| Nevada** | $147.65 | $103.51 |
| New Hampshire | $150.96 | $105.07 |
| New Mexico | $144.49 | $104.06 |
| New Orleans | $145.73 | $104.24 |
| North Carolina | $140.99 | $99.85 |
| North Dakota** | $144.01 | $99.92 |
| Northern Nj | $165.59 | $114.44 |
| Nyc Suburbs/Long Island | $174.39 | $121.97 |
| Ohio | $142.58 | $102.33 |
| Oklahoma | $139.17 | $99.80 |
| Oxnard-Thousand Oaks-Ventura | $161.18 | $109.06 |
| Portland | $156.12 | $107.14 |
| Poughkpsie/N Nyc Suburbs | $160.76 | $112.48 |
| Puerto Rico | $149.66 | $105.08 |
| Queens | $170.41 | $118.29 |
| Redding | $153.34 | $105.02 |
| Rest Of California | $153.34 | $105.02 |
| Rest Of Florida | $149.91 | $107.76 |
| Rest Of Georgia | $142.56 | $103.24 |
| Rest Of Illinois | $147.22 | $106.96 |
| Rest Of Louisiana | $140.09 | $101.07 |
| Rest Of Maine | $139.88 | $99.32 |
| Rest Of Maryland | $149.84 | $105.22 |
| Rest Of Massachusetts | $152.27 | $105.84 |
| Rest Of Michigan | $143.59 | $103.34 |
| Rest Of Missouri | $138.52 | $100.51 |
| Rest Of New Jersey | $159.26 | $111.11 |
| Rest Of New York | $142.78 | $100.90 |
| Rest Of Oregon | $146.19 | $102.28 |
| Rest Of Pennsylvania | $142.43 | $101.95 |
| Rest Of Texas | $144.38 | $102.54 |
| Rest Of Washington | $151.77 | $105.34 |
| Rhode Island | $151.78 | $106.23 |
| Riverside-San Bernardino-Ontario | $156.06 | $107.73 |
| Sacramento-Roseville-Folsom | $159.57 | $108.30 |
| Salinas | $158.94 | $107.84 |
| San Diego-Chula Vista-Carlsbad | $161.67 | $108.94 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $181.17 | $119.00 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $180.88 | $118.72 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $185.18 | $121.60 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $184.02 | $120.44 |
| San Luis Obispo-Paso Robles | $156.53 | $106.31 |
| Santa Cruz-Watsonville | $162.43 | $108.86 |
| Santa Maria-Santa Barbara | $159.26 | $107.86 |
| Santa Rosa-Petaluma | $163.99 | $109.85 |
| Seattle (King Cnty) | $167.60 | $113.50 |
| South Carolina | $142.08 | $101.34 |
| South Dakota** | $143.42 | $99.33 |
| Southern Maine | $145.22 | $101.53 |
| Stockton | $153.34 | $105.02 |
| Suburban Chicago | $157.88 | $112.60 |
| Tennessee | $138.35 | $98.28 |
| Utah | $143.67 | $102.22 |
| Vallejo | $172.22 | $114.11 |
| Vermont | $144.10 | $100.45 |
| Virgin Islands | $149.66 | $105.08 |
| Virginia | $145.25 | $101.91 |
| Visalia | $153.34 | $105.02 |
| West Virginia | $142.85 | $104.54 |
| Wisconsin | $140.08 | $97.84 |
| Wyoming** | $146.80 | $102.71 |
| Yuba City | $153.34 | $105.02 |
54231 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.
$134.46
$183.27
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 | $183.27 | 1 |
| AL | $136.08 | 1 |
| AR | $134.46 | 1 |
| AZ | $145.47 | 1 |
| CA | $153.34–$185.18 | 29 |
| CO | $152.68 | 1 |
| CT | $157.76 | 1 |
| DC | $166.70 | 1 |
| DE | $147.57 | 1 |
| FL | $149.91–$164.78 | 3 |
| GA | $142.56–$152.03 | 2 |
| GU | $155.61 | 1 |
| HI | $155.61 | 1 |
| IA | $137.63 | 1 |
| ID | $138.64 | 1 |
| IL | $147.22–$160.62 | 4 |
| IN | $139.26 | 1 |
| KS | $137.71 | 1 |
| KY | $140.03 | 1 |
| LA | $140.09–$145.73 | 2 |
| MA | $152.27–$165.16 | 2 |
| MD | $149.84–$166.70 | 3 |
| ME | $139.88–$145.22 | 2 |
| MI | $143.59–$152.10 | 2 |
| MN | $145.24 | 1 |
| MO | $138.52–$145.43 | 3 |
| MS | $136.48 | 1 |
| MT | $148.95 | 1 |
| NC | $140.99 | 1 |
| ND | $144.01 | 1 |
| NE | $138.06 | 1 |
| NH | $150.96 | 1 |
| NJ | $159.26–$165.59 | 2 |
| NM | $144.49 | 1 |
| NV | $147.65 | 1 |
| NY | $142.78–$174.39 | 5 |
| OH | $142.58 | 1 |
| OK | $139.17 | 1 |
| OR | $146.19–$156.12 | 2 |
| PA | $142.43–$154.82 | 2 |
| PR | $149.66 | 1 |
| RI | $151.78 | 1 |
| SC | $142.08 | 1 |
| SD | $143.42 | 1 |
| TN | $138.35 | 1 |
| TX | $141.70–$152.45 | 8 |
| UT | $143.67 | 1 |
| VA | $145.25–$166.70 | 2 |
| VI | $149.66 | 1 |
| VT | $144.10 | 1 |
| WA | $151.77–$167.60 | 2 |
| WI | $140.08 | 1 |
| WV | $142.85 | 1 |
| WY | $146.80 | 1 |
How the 54231 rate is calculated
Each of 54231’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 · 54231
RVUs × geographic indexes × conversion factor
Work1.99
1.99 RVUs× 1.000 GPCI
Practice expense2.22
2.22 RVUs× 1.000 GPCI
Malpractice0.25
0.25 RVUs× 1.000 GPCI
Adjusted RVUs
4.4600
Conversion factor
$33.4009
Medicare rate
$148.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54231
The CMS indicators that decide how 54231 is paid alongside other services.
CMS payment indicators · 54231
Cavernosometry
| 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
54231 without 51 · national office
$148.97
Cavernosometry
54231-51 · Second procedure: 50%
$74.49
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%).
54231 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 54230Cavernosography
- 54230 is the contrast-imaging procedure for cavernosography. Use 54231 for dynamic pressure and flow measurements; both may be performed during the same diagnostic evaluation.
- 54235Penile injection
- 54235 describes injection of a therapeutic agent into the corpora cavernosa. It does not represent the dynamic pressure-and-flow assessment reported with 54231.
- 54240Penile plethysmography
- 54240 is penile plethysmography, a separate method of evaluating erectile response. Choose 54231 when the clinician performs invasive cavernosal pressure and flow measurements.
- 54250Nocturnal erection testing
- 54250 evaluates nocturnal penile tumescence and rigidity. It is distinct from the induced, invasive hemodynamic study reported with 54231.
54231 billing questions
How is 54231 different from cavernosography?
54231 reports dynamic pressure and flow measurements during a pharmacologically induced erection. Cavernosography uses contrast imaging to show penile venous anatomy and may be performed with cavernosometry.
Does the pharmacologic injection alone support 54231?
No. The service involves a dynamic hemodynamic assessment, not simply injecting an agent into the corpora cavernosa.
What documentation supports reporting this code?
Document the clinical reason for the study, the pharmacologic response, the pressure and flow measurements, and the clinician’s interpretation of the findings.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor and anatomy.
How does the multiple-procedure reduction affect payment?
When 54231 is performed with other procedures in the same session, the highest-valued procedure is paid in full and the other procedure or procedures are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and 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
Fee sheets
Put 54231 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →