Billing code 54435: Penile repairMedicare rate & RVUs in Utah
Repair a penile fracture by surgically exposing and closing the injured erectile tissue, typically after an acute bending injury to an erect penis.
CMS doesn’t publish an office rate for 54435 in Utah.
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 54435 covers
A urologist uses this code for operative repair of a penile fracture, usually a tear in the tunica albuginea after forceful bending of an erect penis. The procedure generally involves surgical exploration, management of the associated hematoma, and closure of the tunical defect. It is typically performed in an operating room, often in a hospital or ambulatory surgical setting. The operative report should identify the fracture and describe the repair performed.
Report this code for fracture repair, not for surgery to correct penile curvature or repair a different penile injury. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during the following 90 days. 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 for this repair. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery 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.
54435 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $372.85 |
How the 54435 rate is calculated
Each of 54435’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 · 54435
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.64Practice expense 3.99Malpractice 0.86
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54435
54435 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54435
Penile repair
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 54435
Penile repair
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
54435 without 51 · national facility
$383.78
Penile repair
54435-51 · Second procedure: 50%
$191.89
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%).
54435 compared with similar codes
Compare codes
54435 vs 54440 vs 54430 vs 54408: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54440Repair of penis
- Choose 54435 for a penile fracture. Code 54440 is for repair of a penile injury other than a fracture.
- 54430Penile reconstruction
- Code 54430 addresses surgical correction of penile angulation, such as with Peyronie's disease; 54435 repairs a traumatic fracture.
- 54408Prosthesis repair
- Code 54408 repairs components of an inflatable penile prosthesis. Code 54435 repairs fractured penile tissue, not implant hardware.
54435 billing questions
How is this code distinguished from 54440?
Use 54435 for repair of a penile fracture. Code 54440 is for repair of a penile injury that is not a fracture.
Is this code used for Peyronie's disease surgery?
No. Code 54435 describes repair of a fracture, while 54430 is used for penile surgery to correct angulation associated with conditions such as Peyronie's disease.
Can a separate penile prosthesis repair be reported?
A repair of prosthesis components is a different service, represented by code 54408. The operative documentation must support that implant-component repair was performed in addition to fracture repair.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. The operative report should document the fracture and its repair.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this repair. Medicare does not pay an assistant at surgery for code 54435.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Co-surgeons and team surgery are not permitted for this code.
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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