Billing code 54417: Penile prosthesisMedicare rate & RVUs in Ohio
Removal and replacement of a penile prosthesis component during one operation, such as when a pump, cylinder, or reservoir requires replacement.
CMS doesn’t publish an office rate for 54417 in Ohio.
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 54417 covers
A urologist reports this service when an implanted penile prosthesis component is removed and replaced during the same operation. The clinical situation may involve a malfunctioning or damaged pump, cylinder, or reservoir while other parts of the prosthesis remain in place. These procedures are generally performed in an operating room or other surgical facility; Medicare recorded facility services for this code in 2024.
The operative report should identify the component removed and the replacement component, describe the reason for the procedure, and clarify whether other prosthesis components were retained. This code represents component replacement, not removal and replacement of the complete device or repair without component replacement. Medicare 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
54417 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $793.06 |
How the 54417 rate is calculated
Each of 54417’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 · 54417
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.70Practice expense 6.58Malpractice 2.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54417
54417 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54417
Penile prosthesis
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 54417
Penile prosthesis
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
54417 without 51 · national facility
$811.64
Penile prosthesis
54417-51 · Second procedure: 50%
$405.82
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%).
54417 compared with similar codes
Compare codes
54417 vs 54410 vs 54406 vs 54408: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54410Prosthesis replacement
- Choose 54410 when the operation removes and replaces the complete multi-component inflatable prosthesis. This code is for removal and replacement of a component.
- 54406Penile prosthesis removal
- 54406 describes removal of a multi-component inflatable prosthesis without replacement. This code requires removal and replacement of a component during the same operation.
- 54408Prosthesis repair
- Use 54408 for repair of a multi-component inflatable prosthesis. Use this code when a component is removed and replaced rather than repaired.
54417 billing questions
When should this code be chosen instead of 54410?
Use this code when a prosthesis component is removed and replaced while the procedure does not replace the complete multi-component device. Code 54410 describes removal and replacement of the complete device.
How does this differ from repair code 54408?
This code describes removing and replacing a component. Code 54408 is for repair of a multi-component inflatable prosthesis rather than replacement of a component.
What operative documentation supports this code?
Document the clinical problem, the specific component removed, the component put in its place, and which other components were retained. The operative note should make clear that removal and replacement occurred during the same operation.
Can modifier 50 be used for bilateral reporting?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
Does the code include postoperative care?
Yes. Medicare assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
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 paid at 50% when performed in the same 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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