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CMS RVU26D · Effective 2026-10-01

54056 Penile lesion destruction Medicare reimbursement rates in Florida

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 Florida.

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 Florida?

Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

$141.85–$154.60

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $12.75 per service.

Facility setting

$99.06–$108.00

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $8.94 per service.

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.

Find 54056 in your payment locality →

Where 54056 pays more and less in Florida

3 payment localities

$141.85 to $154.60

$141.85$148.22$154.60
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

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 Florida, from the same CMS release.

54050

Penile lesion destruction

Chemical method, simple

$143.95–$157.18

54050 describes chemical destruction of penile lesions. Choose 54056 when the method is cryosurgery.

54055

Penile lesion destruction

Extensive treatment

$137.50–$150.28

54055 is for electrosurgical destruction of penile lesions; 54056 is for cryosurgical treatment.

54057

Penile lesion treatment

Laser destruction

$142.40–$156.09

54057 describes laser surgery for penile lesions. It is not the appropriate choice when lesions are frozen.

54065

Penile lesion destruction

Extensive treatment

$221.09–$241.04

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.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

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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.

RVUs for 54056PPRRVU2026_Oct_nonQPP.csv, line 6,240 (RVU26D)