$213.95
54100 represents superficial diagnostic sampling of penile tissue. Choose 54110 when the operative purpose is therapeutic treatment of the lesion rather than obtaining a sample.
On this page
CMS RVU26D · Effective 2026-10-01
54110 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$569.52
Base rate per service
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.
Urology surgery
About 54110: Penile plaque or lesion excision
Surgical treatment of a penile plaque or lesion, commonly a Peyronie's plaque, when the service removes or treats the lesion rather than sampling it for diagnosis.
A urologist typically performs this operation to treat a penile plaque or other lesion, including a Peyronie's plaque associated with curvature. The surgeon treats or removes the abnormal tissue; this is a therapeutic procedure, not a diagnostic sample alone. Medicare claims for this service are predominantly facility-based, such as hospital outpatient or ambulatory surgery settings.
Select the code when the operative report supports treatment of the penile lesion without the graft work represented by related codes. Document the lesion, the therapeutic objective, and the work performed; use a penile biopsy code when the service is diagnostic sampling instead. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 54110
- 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 RVU10.65 · 63%
- Practice expense (office) RVU5.01 · 29%
- Malpractice RVU1.36 · 8%
128
Medicare services in 2024 · #4680 by national volume
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.
54110 compared with similar codes
Office rates for Modesto, from the same CMS release.
$296.03
54105 is for diagnostic biopsy involving deeper penile tissue. It is not the treatment code when the surgeon treats the lesion itself.
No office rate
54111 is a related treatment code with graft work. Use 54110 for the treatment represented here when the documented procedure does not include that graft work.
No office rate
54112 is another graft-associated penile lesion treatment code. Base the choice between it and 54110 on the specific operative work, including whether graft work was performed.
The same code, a different location
How does Modesto compare?
54110 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 54110
Office
Unavailable
Facility
$569.52
No comparable office rate is available.
Merced
California · 54110
Office
Unavailable
Facility
$569.52
No comparable office rate is available.
Napa
California · 54110
Office
Unavailable
Facility
$621.76
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 54110
Office
Unavailable
Facility
$591.77
No comparable office rate is available.
Redding
California · 54110
Office
Unavailable
Facility
$569.52
No comparable office rate is available.
Rest Of California
California · 54110
Office
Unavailable
Facility
$569.52
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 54110
Office
Unavailable
Facility
$584.27
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 54110
Office
Unavailable
Facility
$587.49
No comparable office rate is available.
Salinas
California · 54110
Office
Unavailable
Facility
$585.04
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 54110
Office
Unavailable
Facility
$591.15
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 54110
Office
Unavailable
Facility
$646.31
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 54110
Office
Unavailable
Facility
$644.77
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 54110
Office
Unavailable
Facility
$660.50
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 54110
Office
Unavailable
Facility
$654.18
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 54110
Office
Unavailable
Facility
$576.71
No comparable office rate is available.
Santa Cruz-Watsonville
California · 54110
Office
Unavailable
Facility
$590.85
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 54110
Office
Unavailable
Facility
$585.14
No comparable office rate is available.
Santa Rosa-Petaluma
California · 54110
Office
Unavailable
Facility
$596.23
No comparable office rate is available.
Stockton
California · 54110
Office
Unavailable
Facility
$569.52
No comparable office rate is available.
Vallejo
California · 54110
Office
Unavailable
Facility
$619.53
No comparable office rate is available.
Visalia
California · 54110
Office
Unavailable
Facility
$569.52
No comparable office rate is available.
Yuba City
California · 54110
Office
Unavailable
Facility
$569.52
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 54110
Office
Unavailable
Facility
$622.61
No comparable office rate is available.
Miami
Florida · 54110
Office
Unavailable
Facility
$644.80
No comparable office rate is available.
Chicago
Illinois · 54110
Office
Unavailable
Facility
$630.64
No comparable office rate is available.
Manhattan
New York · 54110
Office
Unavailable
Facility
$644.98
No comparable office rate is available.
Alaska*
Alaska · 54110
Office
Unavailable
Facility
$736.82
No comparable office rate is available.
Alabama
Alabama · 54110
Office
Unavailable
Facility
$527.85
No comparable office rate is available.
Arkansas
Arkansas · 54110
Office
Unavailable
Facility
$522.86
No comparable office rate is available.
Arizona
Arizona · 54110
Office
Unavailable
Facility
$556.75
No comparable office rate is available.
Colorado
Colorado · 54110
Office
Unavailable
Facility
$573.51
No comparable office rate is available.
Connecticut
Connecticut · 54110
Office
Unavailable
Facility
$598.02
No comparable office rate is available.
Delaware
Delaware · 54110
Office
Unavailable
Facility
$563.67
No comparable office rate is available.
Fort Lauderdale
Florida · 54110
Office
Unavailable
Facility
$607.36
No comparable office rate is available.
Rest Of Florida
Florida · 54110
Office
Unavailable
Facility
$583.97
No comparable office rate is available.
Atlanta
Georgia · 54110
Office
Unavailable
Facility
$581.36
No comparable office rate is available.
Rest Of Georgia
Georgia · 54110
Office
Unavailable
Facility
$559.13
No comparable office rate is available.
Hawaii, Guam
Hawaii · 54110
Office
Unavailable
Facility
$572.28
No comparable office rate is available.
Iowa
Iowa · 54110
Office
Unavailable
Facility
$526.87
No comparable office rate is available.
Idaho
Idaho · 54110
Office
Unavailable
Facility
$531.16
No comparable office rate is available.
East St. Louis
Illinois · 54110
Office
Unavailable
Facility
$601.16
No comparable office rate is available.
Rest Of Illinois
Illinois · 54110
Office
Unavailable
Facility
$579.50
No comparable office rate is available.
Suburban Chicago
Illinois · 54110
Office
Unavailable
Facility
$610.56
No comparable office rate is available.
Indiana
Indiana · 54110
Office
Unavailable
Facility
$532.92
No comparable office rate is available.
Kansas
Kansas · 54110
Office
Unavailable
Facility
$529.89
No comparable office rate is available.
Kentucky
Kentucky · 54110
Office
Unavailable
Facility
$546.05
No comparable office rate is available.
New Orleans
Louisiana · 54110
Office
Unavailable
Facility
$564.79
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 54110
Office
Unavailable
Facility
$547.33
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 54110
Office
Unavailable
Facility
$610.53
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 54110
Office
Unavailable
Facility
$573.82
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 54110
Office
Unavailable
Facility
$597.16
No comparable office rate is available.
Rest Of Maryland
Maryland · 54110
Office
Unavailable
Facility
$570.32
No comparable office rate is available.
Rest Of Maine
Maine · 54110
Office
Unavailable
Facility
$537.93
No comparable office rate is available.
Southern Maine
Maine · 54110
Office
Unavailable
Facility
$550.22
No comparable office rate is available.
Detroit
Michigan · 54110
Office
Unavailable
Facility
$593.79
No comparable office rate is available.
Rest Of Michigan
Michigan · 54110
Office
Unavailable
Facility
$559.78
No comparable office rate is available.
Minnesota
Minnesota · 54110
Office
Unavailable
Facility
$541.36
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 54110
Office
Unavailable
Facility
$557.23
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 54110
Office
Unavailable
Facility
$560.54
No comparable office rate is available.
Rest Of Missouri
Missouri · 54110
Office
Unavailable
Facility
$544.21
No comparable office rate is available.
Mississippi
Mississippi · 54110
Office
Unavailable
Facility
$533.37
No comparable office rate is available.
Montana**
Montana · 54110
Office
Unavailable
Facility
$568.39
No comparable office rate is available.
North Carolina
North Carolina · 54110
Office
Unavailable
Facility
$540.87
No comparable office rate is available.
North Dakota**
North Dakota · 54110
Office
Unavailable
Facility
$541.50
No comparable office rate is available.
Nebraska
Nebraska · 54110
Office
Unavailable
Facility
$527.34
No comparable office rate is available.
New Hampshire
New Hampshire · 54110
Office
Unavailable
Facility
$569.67
No comparable office rate is available.
Northern Nj
New Jersey · 54110
Office
Unavailable
Facility
$620.76
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 54110
Office
Unavailable
Facility
$602.51
No comparable office rate is available.
New Mexico
New Mexico · 54110
Office
Unavailable
Facility
$563.72
No comparable office rate is available.
Nevada**
Nevada · 54110
Office
Unavailable
Facility
$561.06
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 54110
Office
Unavailable
Facility
$661.81
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 54110
Office
Unavailable
Facility
$609.93
No comparable office rate is available.
Queens
New York · 54110
Office
Unavailable
Facility
$641.78
No comparable office rate is available.
Rest Of New York
New York · 54110
Office
Unavailable
Facility
$546.63
No comparable office rate is available.
Ohio
Ohio · 54110
Office
Unavailable
Facility
$554.29
No comparable office rate is available.
Oklahoma
Oklahoma · 54110
Office
Unavailable
Facility
$540.45
No comparable office rate is available.
Portland
Oregon · 54110
Office
Unavailable
Facility
$581.12
No comparable office rate is available.
Rest Of Oregon
Oregon · 54110
Office
Unavailable
Facility
$554.32
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 54110
Office
Unavailable
Facility
$590.51
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 54110
Office
Unavailable
Facility
$552.26
No comparable office rate is available.
Puerto Rico
Puerto Rico · 54110
Office
Unavailable
Facility
$569.64
No comparable office rate is available.
Rhode Island
Rhode Island · 54110
Office
Unavailable
Facility
$575.86
No comparable office rate is available.
South Carolina
South Carolina · 54110
Office
Unavailable
Facility
$548.95
No comparable office rate is available.
South Dakota**
South Dakota · 54110
Office
Unavailable
Facility
$538.32
No comparable office rate is available.
Tennessee
Tennessee · 54110
Office
Unavailable
Facility
$532.22
No comparable office rate is available.
Austin
Texas · 54110
Office
Unavailable
Facility
$573.72
No comparable office rate is available.
Beaumont
Texas · 54110
Office
Unavailable
Facility
$550.20
No comparable office rate is available.
Brazoria
Texas · 54110
Office
Unavailable
Facility
$559.83
No comparable office rate is available.
Dallas
Texas · 54110
Office
Unavailable
Facility
$564.57
No comparable office rate is available.
Fort Worth
Texas · 54110
Office
Unavailable
Facility
$563.48
No comparable office rate is available.
Galveston
Texas · 54110
Office
Unavailable
Facility
$562.34
No comparable office rate is available.
Houston
Texas · 54110
Office
Unavailable
Facility
$587.24
No comparable office rate is available.
Rest Of Texas
Texas · 54110
Office
Unavailable
Facility
$555.54
No comparable office rate is available.
Utah
Utah · 54110
Office
Unavailable
Facility
$553.81
No comparable office rate is available.
Virginia
Virginia · 54110
Office
Unavailable
Facility
$552.28
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 54110
Office
Unavailable
Facility
$569.64
No comparable office rate is available.
Vermont
Vermont · 54110
Office
Unavailable
Facility
$544.37
No comparable office rate is available.
Rest Of Washington
Washington · 54110
Office
Unavailable
Facility
$571.12
No comparable office rate is available.
Seattle (King Cnty)
Washington · 54110
Office
Unavailable
Facility
$615.94
No comparable office rate is available.
Wisconsin
Wisconsin · 54110
Office
Unavailable
Facility
$530.02
No comparable office rate is available.
West Virginia
West Virginia · 54110
Office
Unavailable
Facility
$566.14
No comparable office rate is available.
Wyoming**
Wyoming · 54110
Office
Unavailable
Facility
$556.67
No comparable office rate is available.
See how rates vary across the country
54110 · 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 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 54110 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$626.47
$569.52 × 110% = $626.47
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 54110 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
6,246
- Code
- 54110
- Physician work
- 10.65
- Practice expense
- 5.01
- Malpractice
- 1.36
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.65 | × 1.017 | 10.8310 |
| Practice expense | 5.01 | × 1.096 | 5.4910 |
| Malpractice | 1.36 | × 0.536 | 0.7290 |
| Total RVUs | 17.0510 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$569.52
Open 54110 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.65 | 1.017 |
| Practice expense | 5.01 | 1.096 |
| Malpractice | 1.36 | 0.536 |
(10.65 × 1.017 + 5.01 × 1.096 + 1.36 × 0.536) × $33.4009 = $569.52
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
54110 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $569.52 | RVU26D |
| 2026-07-01 | Not available in this setting | $569.52 | RVU26C |
| 2026-04-01 | Not available in this setting | $569.52 | RVU26B |
| 2026-01-01 | Not available in this setting | $569.52 | RVU26A |
| 2025-10-01 | Not available in this setting | $614.89 | RVU25D |
| 2025-07-01 | Not available in this setting | $614.89 | RVU25C |
| 2025-04-01 | Not available in this setting | $614.89 | RVU25B |
| 2025-01-01 | Not available in this setting | $614.89 | RVU25A |
54110 billing questions
When should I report this instead of a penile biopsy code?
Report this service when the operative purpose is to treat the penile plaque or lesion. Use a biopsy code when the service is diagnostic tissue sampling rather than therapeutic removal.
How does this differ from the graft-related penile lesion codes?
This code represents treatment without the graft work associated with 54111 and 54112. Use the code that matches the procedure documented in the operative report.
Can I report a biopsy code for tissue removed during treatment?
Do not select a biopsy code simply because tissue was submitted for examination. The operative purpose and work performed determine whether the service was diagnostic sampling or definitive treatment.
What documentation supports the claim?
Document the penile lesion or plaque, the reason for treatment, and the operative steps that treated or removed it. The report should also make clear whether graft work was performed.
Which modifiers and global-period rules matter?
Modifier 50 is inappropriate for this service. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in its major-surgery global period; an assistant may be paid, but co-surgeon and team-surgery billing are not permitted.
What happens when another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures in that session.
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.
6,24354065,,Destruction penis lesion(s),A,,2.41,4.01,,1.85,,0.25,6.67,4.51,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24454100,,Biopsy of penis,A,,1.85,4.03,,1.06,,0.20,6.08,3.11,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24554105,,Biopsy of penis,A,,3.45,4.67,,1.96,,0.44,8.56,5.85,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24654110,,Treatment of penis lesion,A,,10.65,5.01,NA,5.01,,1.36,17.02,17.02,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24754111,,Treat penis lesion graft,A,,14.06,5.71,NA,5.71,,1.80,21.57,21.57,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24854112,,Treat penis lesion graft,A,,16.56,6.56,NA,6.56,,2.13,25.25,25.25,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24954115,,Treatment of penis lesion,A,,6.78,6.59,,4.20,,0.88,14.25,11.86,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536