$151.79
54050 is for simple chemical destruction. 54055 is selected for extensive destruction, supported by the treatment performed and documented extent.
On this page
CMS RVU26D · Effective 2026-10-01
54055 Penile lesion destruction Medicare reimbursement rates in Colorado
Reports extensive destruction of penile lesions, such as condyloma, when treatment goes beyond simple chemical destruction of a limited lesion. Compare 54055 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 54055 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$144.75
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$88.96
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Urology procedure
About 54055: Extensive penile lesion destruction
Reports extensive destruction of penile lesions, such as condyloma, when treatment goes beyond simple chemical destruction of a limited lesion.
This service covers extensive destruction of lesions on the penis, commonly condyloma (genital warts). A urologist, dermatologist, or other qualified clinician may perform it in an office or procedure setting using an ablative approach such as electrosurgery. The extent of treatment, rather than a particular lesion count, distinguishes it from simple chemical destruction; technique-specific cryosurgery and laser codes are also available.
Report the service when the documented lesion burden and treatment support extensive destruction. Record the penile site, lesion distribution, method, and work performed. The service has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 54055
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.22 · 29%
- Practice expense (office) RVU2.81 · 67%
- Malpractice RVU0.14 · 3%
231
Medicare services in 2024 · #4199 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.
54055 compared with similar codes
Office rates for Colorado, from the same CMS release.
$149.75
54056 identifies cryosurgery for extensive penile lesions. Use 54055 when the service is extensive destruction by a method not identified by that technique-specific code.
$149.47
54057 identifies laser surgery for extensive penile lesions. 54055 covers extensive destruction when laser surgery is not the specified method.
$208.32
54060 is for excision, removing the lesion. 54055 is for destroying it without reporting an excisional approach.
Compare 54055 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$144.75
Facility
$88.96
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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 54055 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,239
- Code
- 54055
- Physician work
- 1.22
- Practice expense
- 2.81
- Malpractice
- 0.14
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.22 | × 1.012 | 1.2346 |
| Practice expense | 2.81 | × 1.064 | 2.9898 |
| Malpractice | 0.14 | × 0.781 | 0.1093 |
| Total RVUs | 4.3338 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$144.75
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.22 | 1.012 |
| Practice expense | 2.81 | 1.064 |
| Malpractice | 0.14 | 0.781 |
(1.22 × 1.012 + 2.81 × 1.064 + 0.14 × 0.781) × $33.4009 = $144.75
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.22 | 1.012 |
| Practice expense | 1.24 | 1.064 |
| Malpractice | 0.14 | 0.781 |
(1.22 × 1.012 + 1.24 × 1.064 + 0.14 × 0.781) × $33.4009 = $88.96
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.
54055 billing questions
How does 54055 differ from 54050?
54055 is for extensive destruction. 54050 describes simple chemical destruction, so the documented extent and method help distinguish the services.
When should a technique-specific code be considered?
Use the applicable sibling when the service is specifically cryosurgery or laser surgery: 54056 identifies cryosurgery and 54057 identifies laser surgery.
Can 54055 be reported with excision code 54060?
The codes describe different approaches: 54055 destroys lesions, while 54060 removes them by excision. Documentation should show which approach was performed.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in 54055.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for 54055.
What documentation supports reporting 54055?
Document the penile site, lesion distribution, why treatment was extensive, the destruction method, and the work performed.
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.
6,23654001,,Slitting of prepuce,A,,2.18,3.64,,1.43,,0.27,6.09,3.88,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23754015,,I&d penis deep,A,,5.23,2.41,NA,2.41,,0.66,8.30,8.30,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23854050,,Destruction penis lesion(s),A,,1.26,2.97,,1.50,,0.14,4.37,2.90,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23954055,,Destruction penis lesion(s),A,,1.22,2.81,,1.24,,0.14,4.17,2.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24054056,,Cryosurgery penis lesion(s),A,,1.26,2.92,,1.58,,0.13,4.31,2.97,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24154057,,Laser surg penis lesion(s),A,,1.26,2.89,,1.31,,0.16,4.31,2.73,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24254060,,Excision of penis lesion(s),A,,1.93,3.85,,1.50,,0.24,6.02,3.67,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899