CPT 54205: Plaque injectionMedicare rate & RVUs in Oregon
Reports medication injection into a Peyronie's disease plaque when the urologist surgically exposes the plaque during the procedure.
CMS doesn’t publish an office rate for 54205 in Oregon.
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 54205 covers
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.
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 54205 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $500.91 |
| Rest Of Oregon | Unavailable | $476.48 |
How the 54205 rate is calculated
Each of 54205’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 · 54205
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.75Practice expense 4.74Malpractice 1.13
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54205
54205 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54205
Plaque injection
| 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 · 54205
Plaque injection
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
54205 without 51 · national facility
$488.32
Plaque injection
54205-51 · Second procedure: 50%
$244.16
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%).
54205 compared with similar codes
Compare codes
54205 vs 54200 vs 54235: national Medicare rates
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How to choose
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 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
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