No office rate
Use 54135 when radical penectomy includes bilateral pelvic lymphadenectomy; 54130 describes the related operation with bilateral inguinal lymphadenectomy.
On this page
CMS RVU26D · Effective 2026-10-01
54135 Penectomy Medicare reimbursement rates in Colorado
Reports radical removal of the penis with bilateral pelvic lymph node dissection, typically as surgical treatment for penile cancer requiring pelvic nodal surgery. Compare 54135 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 54135 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
No supported rate
Facility setting
$1349.25
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.
Urologic surgery
About 54135: Radical penectomy with pelvic lymphadenectomy
Reports radical removal of the penis with bilateral pelvic lymph node dissection, typically as surgical treatment for penile cancer requiring pelvic nodal surgery.
A urologist typically performs this major operation for penile cancer when treatment includes radical removal of the penis and dissection of pelvic lymph nodes on both sides. The service includes the penile operation and the specified nodal surgery; the operative report should identify the extent of resection and the bilateral pelvic node dissection. It is performed in a surgical setting, not as a diagnostic biopsy or limited penile lesion procedure.
Select this code when the operative documentation supports radical penectomy with bilateral pelvic lymphadenectomy, rather than penectomy alone or a less extensive nodal procedure. The code is priced as bilateral, so modifier 50 does not increase payment. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 54135
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- 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 RVU27.47 · 68%
- Practice expense (office) RVU9.24 · 23%
- Malpractice RVU3.54 · 9%
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.
54135 compared with similar codes
Office rates for Colorado, from the same CMS release.
Compare 54135 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
Unavailable
Facility
$1349.25
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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 54135 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,253
- Code
- 54135
- Physician work
- 27.47
- Practice expense
- 9.24
- Malpractice
- 3.54
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 27.47 | × 1.012 | 27.7996 |
| Practice expense | 9.24 | × 1.064 | 9.8314 |
| Malpractice | 3.54 | × 0.781 | 2.7647 |
| Total RVUs | 40.3957 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$1349.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 27.47 | 1.012 |
| Practice expense | 9.24 | 1.064 |
| Malpractice | 3.54 | 0.781 |
(27.47 × 1.012 + 9.24 × 1.064 + 3.54 × 0.781) × $33.4009 = $1349.25
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.
54135 billing questions
How does 54135 differ from 54130?
54135 includes bilateral pelvic lymph node dissection with radical penectomy. 54130 is the related code for radical penectomy with bilateral inguinal lymphadenectomy.
Should modifier 50 be appended?
The code is already priced as bilateral, so modifier 50 does not increase payment.
Can the pelvic node dissection be billed separately?
The nodal dissection is part of this combined service when performed with the radical penectomy described by the code. The operative report should establish that the bilateral pelvic dissection was performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.
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.
6,25054120,,Partial removal of penis,A,,10.73,5.14,NA,5.14,,1.39,17.26,17.26,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25154125,,Removal of penis,A,,14.20,6.21,NA,6.21,,1.96,22.37,22.37,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25254130,,Remove penis & nodes,A,,21.29,7.96,NA,7.96,,2.74,31.99,31.99,0,090,0.10,0.80,0.10,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25354135,,Remove penis & nodes,A,,27.47,9.24,NA,9.24,,3.54,40.25,40.25,0,090,0.10,0.80,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25454150,,Circumcision w/regionl block,A,,1.85,2.46,,0.43,,0.24,4.55,2.52,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25554160,,Circumcision neonate,A,,2.47,4.04,,1.16,,0.33,6.84,3.96,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25654161,,Circum 28 days or older,A,,3.24,1.76,NA,1.76,,0.42,5.42,5.42,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,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