$111.20
Use 54205 when the plaque is surgically exposed before injection; 54200 represents plaque injection without surgical exposure.
On this page
CMS RVU26D · Effective 2026-10-01
54205 Plaque injection Medicare reimbursement rates in Kansas
Reports medication injection into a Peyronie's disease plaque when the urologist surgically exposes the plaque during the procedure. Compare 54205 office and facility rates across CMS payment localities in Kansas.
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 54205 in Kansas?
Kansas 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
$454.40
1 of 1 localities have a supported rate.
Payment area: Kansas
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 procedure
About 54205: Peyronie's plaque injection with exposure
Reports medication injection into a Peyronie's disease plaque when the urologist surgically exposes the plaque during the procedure.
A urologist surgically exposes the fibrous penile plaque associated with Peyronie's disease and injects medication directly into it. This is the operative exposure approach, rather than an injection performed without surgical exposure. The service is generally performed in an operating-room setting by a urologist treating a plaque that causes penile curvature or deformity.
Report this code when the documented procedure includes both surgical exposure of the plaque and injection into it; an injection without exposure is represented by 54200. The operative report should identify the Peyronie's plaque and document its exposure and injection. 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 multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 54205
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.75 · 60%
- Practice expense (office) RVU4.74 · 32%
- Malpractice RVU1.13 · 8%
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.
54205 compared with similar codes
Office rates for Kansas, from the same CMS release.
$87.47
54235 is a therapeutic injection into the corpora cavernosa, not an injection into a surgically exposed Peyronie's plaque.
Compare 54205 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
Kansas →
Office / nonfacility
Unavailable
Facility
$454.40
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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 54205 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
6,261
- Code
- 54205
- Physician work
- 8.75
- Practice expense
- 4.74
- Malpractice
- 1.13
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.75 | × 1.000 | 8.7500 |
| Practice expense | 4.74 | × 0.904 | 4.2850 |
| Malpractice | 1.13 | × 0.504 | 0.5695 |
| Total RVUs | 13.6045 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$454.40
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.75 | 1 |
| Practice expense | 4.74 | 0.904 |
| Malpractice | 1.13 | 0.504 |
(8.75 × 1 + 4.74 × 0.904 + 1.13 × 0.504) × $33.4009 = $454.40
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.
54205 billing questions
How is 54205 different from 54200?
54205 describes injection into a Peyronie's plaque after surgical exposure. Use 54200 for the plaque injection procedure without surgical exposure.
What documentation supports 54205?
The operative report should identify the Peyronie's plaque and describe its surgical exposure and injection. The record should support that both parts of the service were performed.
Does the 90-day global period include postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this service.
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 subject to a 50% reduction.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment for this service. 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.
6,25854163,,Repair of circumcision,A,,3.24,2.54,NA,2.54,,0.42,6.20,6.20,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25954164,,Frenulotomy of penis,A,,2.75,2.44,NA,2.44,,0.36,5.55,5.55,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26054200,,Injection px peyronie ds,A,,1.08,2.41,,1.28,,0.14,3.63,2.50,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26154205,,Njx px peyronie ds exps plaq,A,,8.75,4.74,NA,4.74,,1.13,14.62,14.62,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26254220,,Irrg crpra cavrnosa priapism,A,,2.36,4.76,,1.09,,0.43,7.55,3.88,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26354230,,Njx corpora cavernosograpy,A,,1.31,1.83,,0.71,,0.17,3.31,2.19,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,26454231,,Dynamic cavernosometry,A,,1.99,2.22,,0.90,,0.25,4.46,3.14,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958