CPT code 54115: Penile plaque surgery2026 Medicare rate & RVUs in Florida
Surgical excision of a Peyronie’s plaque with graft reconstruction and graft harvesting, reported when the operative repair includes harvesting tissue for the graft.
Medicare pays $481.06–$529.93 for 54115 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 54115 covers
This operation treats Peyronie’s disease by removing a penile plaque and reconstructing the resulting defect with graft tissue harvested during the procedure. A urologist typically performs the surgery in an operating room when the operative plan calls for plaque excision and graft repair rather than a diagnostic biopsy or plaque excision without grafting.
Select the code from the documented operative work, including plaque excision, graft reconstruction, and graft harvesting. The operative report should identify the plaque treatment, graft use, and harvest. CMS 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. Do not use modifier 50; CMS permits assistant-at-surgery payment but not co-surgeon or team-surgery billing.
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.
Where 54115 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$481.06 to $529.93
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $502.57 | $421.71 |
| Miami | $529.93 | $446.83 |
| Rest Of Florida | $481.06 | $404.75 |
How the 54115 rate is calculated
Each of 54115’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 54115
RVUs × geographic indexes × conversion factor
Work6.78
6.78 RVUs× 1.000 GPCI
Practice expense6.59
6.59 RVUs× 1.000 GPCI
Malpractice0.88
0.88 RVUs× 1.000 GPCI
Adjusted RVUs
14.2500
Conversion factor
$33.4009
Medicare rate
$475.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54115
54115 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54115
Penile plaque surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54115
Penile plaque surgery
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54115 without 51 · national office
$475.96
Penile plaque surgery
54115-51 · Second procedure: 50%
$237.98
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
54115 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 54110Penile lesion treatment
- Use 54110 for plaque excision without grafting. Use 54115 when the operation includes graft reconstruction and harvesting graft tissue.
- 54111Penile lesion surgery
- 54111 applies to plaque excision with a dermal or synthetic graft; 54115 includes graft harvesting as part of the operation.
- 54112Penile plaque surgery
- 54112 applies to plaque excision with a vein graft. For the graft-harvest procedure represented by 54115, the operative report must support harvesting as part of the repair.
- 54100Biopsy
- 54100 is for penile tissue sampling to establish a diagnosis. It does not represent excision of a Peyronie’s plaque with graft reconstruction.
54115 billing questions
How does this differ from 54110?
54115 includes graft reconstruction with graft harvesting as part of the plaque operation. 54110 is for plaque excision without grafting.
Is graft harvesting separately reported?
Graft harvesting is included in 54115. The operative report should support that graft tissue was harvested and used in the reconstruction.
Can modifier 50 be used for bilateral disease?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
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?
CMS allows payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
When is a biopsy code more appropriate?
Use a penile biopsy code when the service is tissue sampling for diagnosis rather than plaque excision with graft reconstruction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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