54440
No office rateRepair of penis
Choose 54435 for a penile fracture. Code 54440 is for repair of a penile injury other than a fracture.
On this page
CMS RVU26D · Effective 2026-10-01
54435 Penile repair Medicare reimbursement rates in Washington
Repair a penile fracture by surgically exposing and closing the injured erectile tissue, typically after an acute bending injury to an erect penis. Compare 54435 office and facility rates across CMS payment localities in Washington.
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 54435 in Washington?
Washington 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
$386.86–$419.86
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.
Urology surgery
About 54435: Penile fracture repair
Repair a penile fracture by surgically exposing and closing the injured erectile tissue, typically after an acute bending injury to an erect penis.
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.
CMS billing rules for 54435
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.64 · 58%
- Practice expense (office) RVU3.99 · 35%
- Malpractice RVU0.86 · 7%
40
Medicare services in 2024 · #5503 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.
54435 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
Code 54430 addresses surgical correction of penile angulation, such as with Peyronie's disease; 54435 repairs a traumatic fracture.
No office rate
Code 54408 repairs components of an inflatable penile prosthesis. Code 54435 repairs fractured penile tissue, not implant hardware.
Compare 54435 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$386.86
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$419.86
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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 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.
6,30154417,,Remv/replc penis pros compl,A,,15.70,6.58,NA,6.58,,2.02,24.30,24.30,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30254420,,Revision of penis,A,,12.08,5.43,NA,5.43,,1.54,19.05,19.05,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30354430,,Revision of penis,A,,10.78,5.26,NA,5.26,,1.37,17.41,17.41,0,090,0.10,0.80,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30454435,,Revision of penis,A,,6.64,3.99,NA,3.99,,0.86,11.49,11.49,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30554437,,Repair corporeal tear,A,,11.21,5.90,NA,5.90,,1.44,18.55,18.55,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30654440,,Repair of penis,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30754450,,Preputial stretching,A,,1.09,0.91,,0.27,,0.15,2.15,1.51,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00