No office rate
54120 describes partial removal; 54125 is used when the operation removes the penis completely.
On this page
CMS RVU26D · Effective 2026-10-01
54120 Penile surgery Medicare reimbursement rates in Iowa
Reports surgical removal of part of the penis, commonly for a penile malignancy that requires more tissue removal than a local lesion excision. Compare 54120 office and facility rates across CMS payment localities in Iowa.
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 54120 in Iowa?
Iowa 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
$533.91
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
Urology surgery
About 54120: Partial penile amputation
Reports surgical removal of part of the penis, commonly for a penile malignancy that requires more tissue removal than a local lesion excision.
A urologist removes a portion of the penis while leaving a proximal remnant. This operation is commonly performed for penile cancer when the tumor’s extent makes a limited local excision unsuitable. The procedure is generally done in an operating room, with the operative plan guided by the tumor’s location and extent and the amount of tissue needed for resection. Reconstruction of the urinary outlet may be part of the operative work, depending on the procedure performed.
Report 54120 when the operative record supports partial rather than complete removal, and distinguish it from procedures that also include radical resection and lymph-node dissection. Document the indication, structures and extent removed, and any associated work. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 54120
- 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 RVU10.73 · 62%
- Practice expense (office) RVU5.14 · 30%
- Malpractice RVU1.39 · 8%
352
Medicare services in 2024 · #3853 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.
54120 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
54130 includes radical penile resection with bilateral inguinal lymphadenectomy. 54120 describes partial removal without that specified nodal dissection.
$187.61
54100 is for biopsy of penile tissue to obtain a diagnostic specimen. 54120 reports partial removal of the penis, not a diagnostic biopsy.
Compare 54120 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
Iowa →
Office / nonfacility
Unavailable
Facility
$533.91
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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 54120 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
6,250
- Code
- 54120
- Physician work
- 10.73
- Practice expense
- 5.14
- Malpractice
- 1.39
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.73 | × 1.000 | 10.7300 |
| Practice expense | 5.14 | × 0.915 | 4.7031 |
| Malpractice | 1.39 | × 0.397 | 0.5518 |
| Total RVUs | 15.9849 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$533.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.73 | 1 |
| Practice expense | 5.14 | 0.915 |
| Malpractice | 1.39 | 0.397 |
(10.73 × 1 + 5.14 × 0.915 + 1.39 × 0.397) × $33.4009 = $533.91
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.
54120 billing questions
How does 54120 differ from complete penile removal?
54120 is for partial removal, with a portion of the penis left in place. Use 54125 when the operative service is complete removal.
When is 54120 different from a local lesion excision?
Report 54120 when the operation removes part of the penis, rather than treating or excising a localized lesion while preserving the organ. The operative report should establish the extent of removal.
Does 54120 have a global period?
Yes. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for 54120?
No. The bilateral adjustment does not apply to this procedure, and modifier 50 is inappropriate.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction and paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery payment is 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.
6,24754111,,Treat penis lesion graft,A,,14.06,5.71,NA,5.71,,1.80,21.57,21.57,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24854112,,Treat penis lesion graft,A,,16.56,6.56,NA,6.56,,2.13,25.25,25.25,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,24954115,,Treatment of penis lesion,A,,6.78,6.59,,4.20,,0.88,14.25,11.86,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25054120,,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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136