CPT code 54411: Prosthesis exchange2026 Medicare rate & RVUs in Alaska
Reports removal and replacement of a self-contained inflatable penile implant when the existing device is exchanged for a new implant.
CMS doesn’t publish an office rate for 54411 in Alaska.
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 9 sections
What 54411 covers
A urologist performs this operation when an existing self-contained inflatable penile prosthesis is removed and replaced. This device type differs from a multi-component system with separate cylinders, pump, and reservoir. The work is generally performed in an operating room for a failed or otherwise unsuitable implant; the operative record should identify the device type and describe removal and placement of its components.
Report the exchange only when the existing self-contained device is removed and a replacement is placed. Documentation should support the device configuration, reason for exchange, and operative work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this procedure.
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.
54411 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $1,209.17 |
How the 54411 rate is calculated
Each of 54411’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 · 54411
RVUs × geographic indexes × conversion factor
Work17.89
17.89 RVUs× 1.000 GPCI
Practice expense7.60
7.60 RVUs× 1.000 GPCI
Malpractice2.31
2.31 RVUs× 1.000 GPCI
Adjusted RVUs
27.8000
Conversion factor
$33.4009
Medicare rate
$928.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54411
54411 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54411
Prosthesis exchange
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54411
Prosthesis exchange
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54411 without 51 · national facility
$928.55
Prosthesis exchange
54411-51 · Second procedure: 50%
$464.28
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%).
54411 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 54415Prosthesis removal
- Use 54415 when the self-contained inflatable implant is removed without replacement. Report 54411 when removal is followed by placement of a replacement device.
- 54416Penile prosthesis
- Use 54416 for exchange of a multi-component inflatable system with separate components. This code is for a self-contained inflatable device.
- 54410Prosthesis replacement
- Use 54410 for exchange of a non-inflatable, semi-rigid implant. This code describes exchange of a self-contained inflatable implant.
- 54417Penile prosthesis
- Use 54417 for a complicated exchange of a multi-component inflatable implant. This code describes exchange of a self-contained inflatable device.
54411 billing questions
How is this different from 54416?
This code is for exchanging a self-contained inflatable implant. Code 54416 describes exchange of a multi-component inflatable system.
Can removal or insertion alone be reported with this exchange?
This code covers removal and replacement together. Removal without replacement or insertion without removal is a different service and should be evaluated under the code for that work.
What documentation supports reporting the exchange?
Document the existing implant’s configuration, why it was exchanged, removal of the existing device, and placement of the replacement.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this procedure; it is not reported as a bilateral service.
How does the 90-day global period affect follow-up?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
When can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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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