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Billing code 54410: Prosthesis replacementMedicare rate & RVUs

Reports operative removal and same-session replacement of a non-inflatable penile prosthesis, such as semi-rigid rods, when the complete device is exchanged.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $782.25 for 54410 nationally in a facility.

Medicare rate · 54410

Prosthesis replacement

Swap in your local Medicare rate.

Work RVUs
14.8
Total RVUs
23.42
Global days
090

National rate · 2026

$782.25

Facility setting, before claim adjustments.

See every locality for 54410 → · 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 54410 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 54410 covers

A urologist reports this service when removing an existing non-inflatable penile prosthesis and placing a replacement during the same operation. These devices use semi-rigid rods rather than an inflatable pump system. The procedure is typically performed in an operating room or other surgical setting for a device that needs complete exchange, such as because of malfunction or wear.

Choose this code when the operative record supports removal and replacement of the non-inflatable device in the same session; it is not the code for removal alone or for an inflatable prosthesis. Document the device type, the work performed to remove it, and placement of the replacement. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is not appropriate for this service. Assistant-at-surgery payment may be available; co-surgeon claims require 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 54410 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

54410 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$726.55
Alaska*Unavailable$1,015.34
ArizonaUnavailable$766.11
ArkansasUnavailable$719.71
AtlantaUnavailable$800.14
AustinUnavailable$788.96
BakersfieldUnavailable$788.21
Baltimore/Surr. CntysUnavailable$821.64
BeaumontUnavailable$757.55
BrazoriaUnavailable$770.15

54410 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
54410 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 54410 rate is calculated

Each of 54410’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 · 54410

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.80Practice expense 6.71Malpractice 1.91

23.4200 adjusted RVUs×$33.4009 conversion factor=$782.25

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 54410

54410 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54410

Prosthesis replacement

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 · 54410

Prosthesis replacement

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

54410 without 51 · national facility

$782.25

Prosthesis replacement

54410-51 · Second procedure: 50%

$391.13

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

54410 compared with similar codes

Compare codes

54410 vs 54411 vs 54415 vs 54400 vs 54406: national Medicare rates

Swap in your local Medicare rate.

  • 54410
    Prosthesis replacement · 14.8 wRVU
    —
  • 54411
    Prosthesis exchange · 17.89 wRVU
    —
  • 54415
    Prosthesis removal · 8.66 wRVU
    —
  • 54400
    Penile prosthesis · 8.94 wRVU
    —
  • 54406
    Penile prosthesis removal · 12.57 wRVU
    —

How to choose

54411Prosthesis exchange
Use 54411 for same-session replacement of a multi-component inflatable device; this code is for a non-inflatable, semi-rigid prosthesis.
54415Prosthesis removal
Use 54415 when the non-inflatable prosthesis is removed without a replacement during the session. This code includes replacement.
54400Penile prosthesis
Code 54400 is for inserting a non-inflatable prosthesis, not exchanging an existing one in the same operation.
54406Penile prosthesis removal
Code 54406 is for removal without replacement of a multi-component inflatable prosthesis; this code includes replacement of a non-inflatable device.

Codes related to 54410

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

Codes related to 54410
CodeHow it relatesNational office range
Same family
54411Prosthesis exchangeReplacement code for a multi-component inflatable penile prosthesis.No office rate
54400Penile prosthesisInsertion of a non-inflatable prosthesis when the service is implantation rather than device exchange.No office rate
54405Penile prosthesisInsertion of a multi-component inflatable penile prosthesis.No office rate
Used instead
54415Prosthesis removalReports removal of a non-inflatable prosthesis when no replacement is placed.No office rate
54406Penile prosthesis removalRemoval-only service for a multi-component inflatable prosthesis.No office rate

54410 billing questions

How is this different from 54411?

This code is for replacing a non-inflatable, semi-rigid device. Code 54411 is for replacement of a multi-component inflatable prosthesis.

Can removal and replacement be billed separately?

No. The service includes removing the existing semi-rigid prosthesis and placing its replacement in the same operative session.

When should 54415 be reported instead?

Use 54415 when the non-inflatable prosthesis is removed without replacement during that session.

Is modifier 50 appropriate?

No. Modifier 50 is not appropriate for this single-device replacement service.

What postoperative care is included?

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

What documentation supports the code?

Document that the existing prosthesis is non-inflatable, that it was removed, and that a replacement was placed during the same operation.

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 54410PPRRVU2026_Oct_nonQPP.csv, line 6,297 (RVU26D)

Open CMS sourceHow we calculate rates

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