No office rate
Choose 54410 when the operation removes and replaces the complete multi-component inflatable prosthesis. This code is for removal and replacement of a component.
On this page
CMS RVU26D · Effective 2026-10-01
54417 Penile prosthesis Medicare reimbursement rates in Delaware
Removal and replacement of a penile prosthesis component during one operation, such as when a pump, cylinder, or reservoir requires replacement. Compare 54417 office and facility rates across CMS payment localities in Delaware.
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 54417 in Delaware?
Delaware 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
$804.81
1 of 1 localities have a supported rate.
Payment area: Delaware
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 54417: Penile prosthesis component replacement
Removal and replacement of a penile prosthesis component during one operation, such as when a pump, cylinder, or reservoir requires replacement.
A urologist reports this service when an implanted penile prosthesis component is removed and replaced during the same operation. The clinical situation may involve a malfunctioning or damaged pump, cylinder, or reservoir while other parts of the prosthesis remain in place. These procedures are generally performed in an operating room or other surgical facility; Medicare recorded facility services for this code in 2024.
The operative report should identify the component removed and the replacement component, describe the reason for the procedure, and clarify whether other prosthesis components were retained. This code represents component replacement, not removal and replacement of the complete device or repair without component replacement. Medicare assigns a 90-day global period, including 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 other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 54417
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.70 · 65%
- Practice expense (office) RVU6.58 · 27%
- Malpractice RVU2.02 · 8%
43
Medicare services in 2024 · #5455 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.
54417 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
54406 describes removal of a multi-component inflatable prosthesis without replacement. This code requires removal and replacement of a component during the same operation.
No office rate
Use 54408 for repair of a multi-component inflatable prosthesis. Use this code when a component is removed and replaced rather than repaired.
Compare 54417 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
Delaware →
Office / nonfacility
Unavailable
Facility
$804.81
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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 54417 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,301
- Code
- 54417
- Physician work
- 15.70
- Practice expense
- 6.58
- Malpractice
- 2.02
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.70 | × 1.005 | 15.7785 |
| Practice expense | 6.58 | × 0.988 | 6.5010 |
| Malpractice | 2.02 | × 0.899 | 1.8160 |
| Total RVUs | 24.0955 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$804.81
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.7 | 1.005 |
| Practice expense | 6.58 | 0.988 |
| Malpractice | 2.02 | 0.899 |
(15.7 × 1.005 + 6.58 × 0.988 + 2.02 × 0.899) × $33.4009 = $804.81
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.
54417 billing questions
When should this code be chosen instead of 54410?
Use this code when a prosthesis component is removed and replaced while the procedure does not replace the complete multi-component device. Code 54410 describes removal and replacement of the complete device.
How does this differ from repair code 54408?
This code describes removing and replacing a component. Code 54408 is for repair of a multi-component inflatable prosthesis rather than replacement of a component.
What operative documentation supports this code?
Document the clinical problem, the specific component removed, the component put in its place, and which other components were retained. The operative note should make clear that removal and replacement occurred during the same operation.
Can modifier 50 be used for bilateral reporting?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
Does the code include postoperative care?
Yes. Medicare assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same 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.
6,29854411,,Remov/replc penis pros comp,A,,17.89,7.60,NA,7.60,,2.31,27.80,27.80,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,29954415,,Remove self-contd penis pros,A,,8.66,4.87,NA,4.87,,1.13,14.66,14.66,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30054416,,Remv/repl penis contain pros,A,,11.78,6.33,NA,6.33,,1.50,19.61,19.61,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30154417,,Remv/replc penis pros compl,A,,15.70,6.58,NA,6.58,,2.02,24.30,24.30,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30254420,,Revision of penis,A,,12.08,5.43,NA,5.43,,1.54,19.05,19.05,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30354430,,Revision of penis,A,,10.78,5.26,NA,5.26,,1.37,17.41,17.41,0,090,0.10,0.80,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30454435,,Revision of penis,A,,6.64,3.99,NA,3.99,,0.86,11.49,11.49,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503