Billing code 54110: Penile lesion treatmentMedicare rate & RVUs in Guam
Surgical treatment of a penile plaque or lesion, commonly a Peyronie's plaque, when the service removes or treats the lesion rather than sampling it for diagnosis.
CMS doesn’t publish an office rate for 54110 in Guam.
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 54110 covers
A urologist typically performs this operation to treat a penile plaque or other lesion, including a Peyronie's plaque associated with curvature. The surgeon treats or removes the abnormal tissue; this is a therapeutic procedure, not a diagnostic sample alone. Medicare claims for this service are predominantly facility-based, such as hospital outpatient or ambulatory surgery settings.
Select the code when the operative report supports treatment of the penile lesion without the graft work represented by related codes. Document the lesion, the therapeutic objective, and the work performed; use a penile biopsy code when the service is diagnostic sampling instead. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon and team-surgery billing are not permitted.
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.
54110 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $572.28 |
How the 54110 rate is calculated
Each of 54110’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 · 54110
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.65Practice expense 5.01Malpractice 1.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54110
54110 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54110
Penile lesion treatment
| 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 · 54110
Penile lesion treatment
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
54110 without 51 · national facility
$568.48
Penile lesion treatment
54110-51 · Second procedure: 50%
$284.24
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%).
54110 compared with similar codes
Compare codes
54110 vs 54100 vs 54105 vs 54111 vs 54112: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54100Biopsy
- 54100 represents superficial diagnostic sampling of penile tissue. Choose 54110 when the operative purpose is therapeutic treatment of the lesion rather than obtaining a sample.
- 54105Penile biopsy
- 54105 is for diagnostic biopsy involving deeper penile tissue. It is not the treatment code when the surgeon treats the lesion itself.
- 54111Penile lesion surgery
- 54111 is a related treatment code with graft work. Use 54110 for the treatment represented here when the documented procedure does not include that graft work.
- 54112Penile plaque surgery
- 54112 is another graft-associated penile lesion treatment code. Base the choice between it and 54110 on the specific operative work, including whether graft work was performed.
54110 billing questions
When should I report this instead of a penile biopsy code?
Report this service when the operative purpose is to treat the penile plaque or lesion. Use a biopsy code when the service is diagnostic tissue sampling rather than therapeutic removal.
How does this differ from the graft-related penile lesion codes?
This code represents treatment without the graft work associated with 54111 and 54112. Use the code that matches the procedure documented in the operative report.
Can I report a biopsy code for tissue removed during treatment?
Do not select a biopsy code simply because tissue was submitted for examination. The operative purpose and work performed determine whether the service was diagnostic sampling or definitive treatment.
What documentation supports the claim?
Document the penile lesion or plaque, the reason for treatment, and the operative steps that treated or removed it. The report should also make clear whether graft work was performed.
Which modifiers and global-period rules matter?
Modifier 50 is inappropriate for this service. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in its major-surgery global period; an assistant may be paid, but co-surgeon and team-surgery billing are not permitted.
What happens when another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures in that 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 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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