Billing code 54410: Prosthesis replacementMedicare rate & RVUs in Washington
Reports operative removal and same-session replacement of a non-inflatable penile prosthesis, such as semi-rigid rods, when the complete device is exchanged.
CMS doesn’t publish an office rate for 54410 in Washington.
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 54410 covers
A urologist reports this service when removing an existing non-inflatable penile prosthesis and placing a replacement during the same operation. These devices use semi-rigid rods rather than an inflatable pump system. The procedure is typically performed in an operating room or other surgical setting for a device that needs complete exchange, such as because of malfunction or wear.
Choose this code when the operative record supports removal and replacement of the non-inflatable device in the same session; it is not the code for removal alone or for an inflatable prosthesis. Document the device type, the work performed to remove it, and placement of the replacement. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is not appropriate for this service. Assistant-at-surgery payment may be available; co-surgeon claims require supporting documentation, and team surgery is 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 54410 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $785.31 |
| Seattle (King Cnty) | Unavailable | $846.17 |
How the 54410 rate is calculated
Each of 54410’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 · 54410
RVUs × geographic indexes × conversion factor
Work14.80
14.80 RVUs× 1.000 GPCI
Practice expense6.71
6.71 RVUs× 1.000 GPCI
Malpractice1.91
1.91 RVUs× 1.000 GPCI
Adjusted RVUs
23.4200
Conversion factor
$33.4009
Medicare rate
$782.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54410
54410 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54410
Prosthesis replacement
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 54410
Prosthesis replacement
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
54410 without 51 · national facility
$782.25
Prosthesis replacement
54410-51 · Second procedure: 50%
$391.13
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%).
54410 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 54411Prosthesis exchange
- Use 54411 for same-session replacement of a multi-component inflatable device; this code is for a non-inflatable, semi-rigid prosthesis.
- 54415Prosthesis removal
- Use 54415 when the non-inflatable prosthesis is removed without a replacement during the session. This code includes replacement.
- 54400Penile prosthesis
- Code 54400 is for inserting a non-inflatable prosthesis, not exchanging an existing one in the same operation.
- 54406Penile prosthesis removal
- Code 54406 is for removal without replacement of a multi-component inflatable prosthesis; this code includes replacement of a non-inflatable device.
54410 billing questions
How is this different from 54411?
This code is for replacing a non-inflatable, semi-rigid device. Code 54411 is for replacement of a multi-component inflatable prosthesis.
Can removal and replacement be billed separately?
No. The service includes removing the existing semi-rigid prosthesis and placing its replacement in the same operative session.
When should 54415 be reported instead?
Use 54415 when the non-inflatable prosthesis is removed without replacement during that session.
Is modifier 50 appropriate?
No. Modifier 50 is not appropriate for this single-device replacement service.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
What documentation supports the code?
Document that the existing prosthesis is non-inflatable, that it was removed, and that a replacement was placed during the same operation.
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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