No office rate
Choose 54130 for bilateral inguinal lymph node dissection and 54135 for bilateral pelvic lymph node dissection with radical penile resection.
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CMS RVU26D · Effective 2026-10-01
54130 Radical penectomy Medicare reimbursement rates in Pennsylvania
Reports radical removal of the penis with bilateral inguinal lymph node dissection, typically for penile cancer requiring resection and nodal treatment. Compare 54130 office and facility rates across CMS payment localities in Pennsylvania.
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 54130 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1041.66–$1109.86
2 of 2 localities have a supported rate.
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.
Urologic surgery
About 54130: Radical penectomy with bilateral inguinal node dissection
Reports radical removal of the penis with bilateral inguinal lymph node dissection, typically for penile cancer requiring resection and nodal treatment.
This major urologic operation removes the penis as part of a radical resection and includes dissection of inguinal lymph nodes on both sides. Urologists typically perform it in an operating room for penile cancer when the operative plan calls for both the primary tumor resection and bilateral inguinal nodal surgery. The included nodal work distinguishes this service from penile amputation without lymphadenectomy and from procedures addressing pelvic nodes.
Report 54130 when the operative documentation supports radical penile resection and bilateral inguinal lymph node dissection. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The code is priced as bilateral, so modifier 50 does not increase payment. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 54130
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- 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 RVU21.29 · 67%
- Practice expense (office) RVU7.96 · 25%
- Malpractice RVU2.74 · 9%
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.
54130 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
54125 describes complete penile amputation without the bilateral inguinal lymphadenectomy included in 54130.
No office rate
54120 is for partial penile amputation; 54130 represents radical resection with bilateral inguinal node dissection.
$191.67–$211.00
54100 is a penile biopsy for tissue diagnosis, not radical resection with bilateral inguinal node dissection.
Compare 54130 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1109.86
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1041.66
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54130 billing questions
How does 54130 differ from 54135?
54130 includes bilateral inguinal lymph node dissection. 54135 is the related radical penile resection code for bilateral pelvic lymph node dissection.
Can the bilateral node dissection be billed separately?
The bilateral inguinal node dissection is part of 54130. The operative report should document the nodal work performed on both sides.
Should modifier 50 be appended?
The code is already priced as bilateral, and modifier 50 does not increase payment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery 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.
6,24954115,,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
6,25454150,,Circumcision w/regionl block,A,,1.85,2.46,,0.43,,0.24,4.55,2.52,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25554160,,Circumcision neonate,A,,2.47,4.04,,1.16,,0.33,6.84,3.96,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00