No office rate
54120 is for partial removal; 54125 requires removal of the entire penis.
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CMS RVU26D · Effective 2026-10-01
54125 Penectomy Medicare reimbursement rates in Rhode Island
Reports surgery removing the entire penis, typically for extensive penile cancer when an organ-preserving operation cannot adequately treat the disease. Compare 54125 office and facility rates across CMS payment localities in Rhode Island.
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 54125 in Rhode Island?
Rhode Island 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
$755.96
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 54125: Complete penile removal
Reports surgery removing the entire penis, typically for extensive penile cancer when an organ-preserving operation cannot adequately treat the disease.
This code describes an operation removing the entire penis, rather than only a portion. Urologists typically perform it in an operating room for extensive penile cancer that cannot be managed with organ-preserving treatment. Urinary drainage may require a perineal urethrostomy; the operative report should make the extent of penile removal clear and describe any associated procedures.
Report the code when the operative documentation supports complete removal, not partial removal or treatment of a penile lesion. A major-surgery global period includes 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% reduction. Modifier 50 is not appropriate for removal of this single organ. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 54125
- 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 RVU14.20 · 63%
- Practice expense (office) RVU6.21 · 28%
- Malpractice RVU1.96 · 9%
180
Medicare services in 2024 · #4423 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.
54125 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
54130 describes radical penile resection with bilateral inguinal lymphadenectomy, not complete penile removal alone.
No office rate
54135 describes radical penile resection with additional lymphadenectomy; select based on the documented extent of nodal surgery.
$207.97
54100 is a penile biopsy for tissue diagnosis, not definitive removal of the entire penis.
Compare 54125 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$755.96
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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 54125 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,251
- Code
- 54125
- Physician work
- 14.20
- Practice expense
- 6.21
- Malpractice
- 1.96
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.20 | × 1.019 | 14.4698 |
| Practice expense | 6.21 | × 1.033 | 6.4149 |
| Malpractice | 1.96 | × 0.892 | 1.7483 |
| Total RVUs | 22.6330 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$755.96
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.2 | 1.019 |
| Practice expense | 6.21 | 1.033 |
| Malpractice | 1.96 | 0.892 |
(14.2 × 1.019 + 6.21 × 1.033 + 1.96 × 0.892) × $33.4009 = $755.96
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.
54125 billing questions
When should 54125 be chosen over 54120?
Use 54125 when the entire penis is removed. Use 54120 when the operation removes only part of it.
Does 54125 include inguinal lymph node removal?
The code describes complete penile removal. When the operation also includes radical resection with inguinal lymphadenectomy, compare the applicable 54130 or 54135 code and document the nodal procedure.
Should modifier 50 be reported?
No. Modifier 50 is not appropriate for removal of the penis as a single organ.
What documentation supports 54125?
The operative report should establish that the entire penis was removed and describe the indication, such as extensive penile cancer, and the extent of the operation.
How does the global period affect postoperative billing?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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.
6,24854112,,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
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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537