Billing code 54240: Penile plethysmographyMedicare rate & RVUs in Utah
Penile plethysmography records penile response to controlled stimuli for a documented physiologic assessment of erectile or sexual arousal response.
Medicare pays $108.72 for 54240 in the office in Utah (Utah). Which amount applies depends on the service address.
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 54240 covers
Penile plethysmography measures changes in penile circumference or volume while a patient is exposed to a controlled stimulus protocol. A trained clinician or staff member conducts the test, and a physician interprets the recorded response. It is used in specialized urology or sexual-medicine evaluations when the question concerns the physiologic response to stimuli, rather than sleep-related erections or anatomy alone.
Report 54240 when this measurement and interpretation are performed; documentation should identify the protocol, recorded response, clinical question, and interpretation. The global service includes same-day preoperative and postoperative care. The global service may be billed without a component modifier, or the interpretation with modifier 26 and the equipment and staff with modifier TC. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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.
54240 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $108.72 | Unavailable |
How the 54240 rate is calculated
Each of 54240’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 · 54240
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.28Practice expense 1.91Malpractice 0.20
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54240
The CMS indicators that decide how 54240 is paid alongside other services.
CMS payment indicators · 54240
Penile plethysmography
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
54240 without 26 · national office
$113.23
Penile plethysmography
54240-26 · Professional component
$66.47
Pays only the interpretation and report.
54240 compared with similar codes
Compare codes
54240 vs 54250 vs 54230 vs 54231: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54250Nocturnal erection testing
- Choose 54240 for stimulus-associated penile response measurement; choose 54250 for testing nocturnal tumescence and rigidity during sleep.
- 54230Cavernosography
- 54230 is cavernosography, an imaging study of the corpora after injection. It does not measure the stimulus-response signal captured by 54240.
- 54231Cavernosometry
- 54231 assesses cavernosal hemodynamics with dynamic testing; 54240 records changes in penile circumference or volume during a stimulus protocol.
54240 billing questions
How is 54240 different from 54250?
54240 measures penile response during a controlled stimulus protocol. 54250 evaluates nocturnal penile tumescence and rigidity during sleep.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the physician's interpretation or modifier TC for the equipment and staff; without either modifier, the claim represents the global service.
What documentation supports 54240?
Document the clinical question, stimulus protocol, recorded penile response, and physician interpretation so the record shows that plethysmography was performed.
Should modifier 50 be used for bilateral testing?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Assistant-at-surgery payment requires documented medical necessity, while co-surgeon and team-surgery billing 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
Show the CMS file lines behind this rate
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