$151.79
54050 describes chemical destruction of penile lesions. Choose 54056 when the method is cryosurgery.
On this page
CMS RVU26D · Effective 2026-10-01
54056 Penile lesion destruction Medicare reimbursement rates in Colorado
Report this service when a clinician treats one or more penile lesions by freezing, such as condylomata, rather than by another destruction method. Compare 54056 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 54056 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
$149.75
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$102.13
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.
Genital lesion treatment
About 54056: Penile lesion cryosurgery
Report this service when a clinician treats one or more penile lesions by freezing, such as condylomata, rather than by another destruction method.
This service uses cryosurgery to freeze and destroy one or more lesions on the penis. Common examples include condylomata and other localized lesions suitable for this technique. Urologists, dermatologists, and other clinicians who treat genital lesions may perform it, commonly in an office setting. The selected code reflects the penile site and the cryosurgical method, not simply the presence of a lesion or the number treated.
Document the treated site or sites, the cryosurgical technique, and the clinical findings supporting treatment. Related postoperative visits during the 10-day global period are included. 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% multiple-procedure 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.
CMS billing rules for 54056
- 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 RVU1.26 · 29%
- Practice expense (office) RVU2.92 · 68%
- Malpractice RVU0.13 · 3%
5K
Medicare services in 2024 · #1864 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.
54056 compared with similar codes
Office rates for Colorado, from the same CMS release.
$144.75
54055 is for electrosurgical destruction of penile lesions; 54056 is for cryosurgical treatment.
$149.47
54057 describes laser surgery for penile lesions. It is not the appropriate choice when lesions are frozen.
$230.49
54065 is used for extensive penile lesion destruction. 54056 describes cryosurgery; select based on the service performed and its extent.
Compare 54056 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
$149.75
Facility
$102.13
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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 54056 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,240
- Code
- 54056
- Physician work
- 1.26
- Practice expense
- 2.92
- Malpractice
- 0.13
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.26 | × 1.012 | 1.2751 |
| Practice expense | 2.92 | × 1.064 | 3.1069 |
| Malpractice | 0.13 | × 0.781 | 0.1015 |
| Total RVUs | 4.4835 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$149.75
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.26 | 1.012 |
| Practice expense | 2.92 | 1.064 |
| Malpractice | 0.13 | 0.781 |
(1.26 × 1.012 + 2.92 × 1.064 + 0.13 × 0.781) × $33.4009 = $149.75
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.26 | 1.012 |
| Practice expense | 1.58 | 1.064 |
| Malpractice | 0.13 | 0.781 |
(1.26 × 1.012 + 1.58 × 1.064 + 0.13 × 0.781) × $33.4009 = $102.13
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.
54056 billing questions
When should 54056 be chosen over 54050 or 54055?
Use 54056 when the penile lesion is destroyed by cryosurgery. Codes 54050 and 54055 describe chemical and electrosurgical destruction, respectively.
Does the code cover more than one penile lesion?
The service covers one or more penile lesions treated with cryosurgery. Document the treated sites and the technique used.
Are related postoperative visits separately included?
Related postoperative visits during the 10-day global period are included in the procedure.
Should modifier 50 be appended for lesions on both sides?
No. The descriptor or anatomy makes modifier 50 inappropriate for this code.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard 50% multiple-procedure reduction. Medicare does not pay an assistant at surgery, 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 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.
6,23754015,,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
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
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