CPT 54400 Surgery - Male Genital
Insert semi-rigid prosthesis Cost
Body System: Reproductive
Medicare Facility Rate
$485
CMS PFS CY2026
Medicare Non-Facility Rate
$485
Office/clinic setting
Hospital Outpatient
$13
OPPS rate
Surgery Center (ASC)
$11
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
8.94
Work RVU
4.43
Facility PE RVU
1.15
Malpractice RVU
14.52
Total RVU
Frequently Asked Questions
How much does Insert semi-rigid prosthesis cost?
The Medicare facility rate is $485. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $13. Ambulatory surgery center rate: $11.
How much does Insert semi-rigid prosthesis cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $485.