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CPT 54130: Total Penectomy with Inguinal Lymphadenectomy

CPT code 54130 denotes a total penectomy with regional inguinal lymph node dissection, an extensive oncologic operation used for advanced or treatment-refractory penile cancer. Nationally, this code represents a low-volume but high-acuity surgical service with significant implications for inpatient surgical capacity, perioperative quality measures, and long-term survivorship care.

Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, expected site-of-service patterns, and a framework for interpreting utilization and coverage considerations for major oncologic genitourinary surgeries.

The publication summarizes benchmarks for utilization and reimbursement where available, highlights relevant clinical context for case selection and expected care pathways, and identifies common policy levers that payers use to manage access and authorization for high-cost, high-complexity inpatient procedures. Data not available in the input will be noted as such in the detailed sections.

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Billing Code Overview

CPT code 54130 describes a surgical procedure in which the provider performs a total penectomy with removal of regional inguinal lymph nodes. The procedure is performed to treat penile cancer that is unresponsive to standard therapies or when the tumor is large or deeply invasive.

Service type: Major extirpative oncologic surgery
Typical site of service: Inpatient hospital surgical setting, often in an operating room with postoperative inpatient care

Find policies, billing codes, payers, states, and providers

CPT 54130: Total Penectomy with Inguinal Lymphadenectomy

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Billing Code Overview

Service type: Major extirpative oncologic surgery
Typical site of service: Inpatient hospital surgical setting, often in an operating room with postoperative inpatient care

Clinical & Coding Specifications

Clinical Context

A typical patient is a male in his 50s–70s presenting with an ulcerative or exophytic penile mass with progressive growth, bleeding, pain, and/or fixed inguinal lymphadenopathy. Prior management often includes biopsy confirming invasive squamous cell carcinoma and staging imaging (CT or PET/CT) demonstrating extensive primary tumor involving the penile shaft and possible regional nodal metastases. Multidisciplinary evaluation (urology, medical oncology, radiation oncology) determines that organ‑preserving surgery or partial penectomy is not feasible due to tumor size, multifocality, or depth of invasion; or the disease is recurrent after prior therapy.

The clinical workflow includes preoperative staging and optimization, informed consent discussing radical penectomy with bilateral inguinal lymphadenectomy, marking of incision lines, general anesthesia, intraoperative removal of the entire penis and relevant superficial and deep inguinal lymph nodes, hemostasis and reconstruction or perineal urethrostomy when indicated, placement of drains, and postoperative monitoring for wound complications, lymphatic drainage issues, and urinary function. Pathology confirms margins and nodal status, guiding adjuvant therapy decisions such as radiation or systemic therapy. Typical site of service is an inpatient surgical setting at an acute care hospital; the service type is major operative oncology surgery for penile cancer.

Coding Specifications

Modifier	Description	When to Use
`11`	Provider part of coordinated team (standard)	When the service is furnished under usual conditions without unusual services; often default for professional component when required by payer documentation.
`22`	Increased procedural services	When work, time, difficulty, or intensity substantially exceeds typical effort for `54130` (document justification).
`23`	Unusual anesthesia for procedure	When the procedure is performed under general anesthesia that is unusually hazardous for the patient due to medical condition.
`50`	Bilateral procedure	When a bilateral inguinal lymphadenectomy is performed in conjunction with penectomy and payer requires bilateral reporting.
`51`	Multiple procedures	When other distinct procedures are performed at the same session (for example, reconstruction, separate urologic procedures).
`52`	Reduced services	When the procedure is intentionally partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the operation is started but terminated due to extenuating circumstances or patient condition.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions of the operation (co-surgeons).
`66`	Surgical team approach	When a surgical team approach is required (e.g., complex reconstruction requiring multiple surgical specialties).
`78`	Unplanned return to OR following initial procedure	For an immediate postoperative return to the operating room for a related procedure during the global period.
`80`	Assistant surgeon	When an assistant surgeon participates and payer requires separate reporting for assistant fee.
`81`	Minimum assistant surgeon	When a minimal assistant role is documented and payer requires reporting.
`82`	Assistant surgeon (when qualified resident not available)	When a qualified resident is not available and an assistant surgeon is required.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist	When an advanced practice clinician performed substantive portion of the service under applicable state law and payer policy.

Taxonomy Code	Specialty	Notes
208000000X	Urology	Primary specialty performing radical penectomy and inguinal lymphadenectomy.
208600000X	Surgical Oncology	Often involved for complex oncologic resections and nodal management.
207XS0102X	General Surgery	May perform inguinal lymphadenectomy in conjunction with urology for complex cases.
363L00000X	Plastic Surgery	Often involved when reconstruction or perineal reconstruction is required after extensive resection.
2084P0800X	Radiation Oncology	Not procedural billing for surgery but part of multidisciplinary team for adjuvant planning; listed as associated specialty.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C60.0`	Malignant neoplasm of prepuce	Penile cancers of the foreskin that may require radical penectomy when extensive.
`C60.1`	Malignant neoplasm of glans penis	Tumors of the glans that can invade deeply and necessitate partial or total penectomy depending on extent; radical penectomy when extensive.
`C60.2`	Malignant neoplasm of body of penis	Primary site requiring resection; extensive disease may require `54130`.
`C60.9`	Malignant neoplasm of penis, unspecified	Used when specific subsite not documented but radical resection indicated.
`C77.1`	Secondary and unspecified malignant neoplasm of inguinal and femoral lymph nodes	Represents regional nodal metastasis prompting concurrent inguinal lymphadenectomy with penectomy.
`Z85.43`	Personal history of malignant neoplasm of penis	Relevant to surveillance and when considering salvage radical surgery for recurrent disease.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`54120`	Partial penectomy (removal of portion of penis)	Performed when tumor extent allows organ preservation; may be an alternative to `54130` for smaller lesions.
`38999`	Unlisted procedure, hemic node dissection or lymph node excision (if specific inguinal nodal codes not applicable)	Used to report atypical or extensive nodal dissections not described by standard codes; may be used adjunctively with penectomy when nodal work exceeds typical descriptors.
`38745`	Radical or modified radical bilateral inguinal lymphadenectomy	Commonly performed at same operative session for regional nodal clearance and staging; directly related to management of penile cancer.
`51960`	Perineal urethrostomy	Performed when urethral diversion is required after radical penectomy to establish a permanent urinary stoma.
`15734`	Muscle, myocutaneous or fasciocutaneous flap; trunk (includes pedicle or free flap)	Performed when reconstructive flap coverage is required for large defects after radical resection.

CPT 54100: Biopsy of Superficial Penile Skin Lesion, Diagnostic

CPT-54105-PENILE-BIOPSY-DEEP-SKIN-LESION

CPT 54105: Biopsy of Penis, Deep Skin Lesion

CPT-54110-PENILE-PLAQUE-EXCISION-PEYRONIES-DISEASE

CPT 54110: Penile Plaque Excision for Peyronie’s Disease

CPT-54111-EXCISION-PLAQUE-PENILE-SKIN-GRAFT-PEYRONIES-DISEASE

CPT 54111: Excision of Penile Plaque with Skin Graft for Peyronie’s Disease

CPT-54112-PENILE-PLA-QUE-EXCISION-SKIN-GRAFT

CPT 54112: Excision of Penile Plaque with Skin Graft >5 cm

CPT-54115-PENILE-IMPLANT-OR-DEEP-PENILE-FOREIGN-BODY-REMOVAL

CPT 54115: Removal of Penile Implant or Deep Penile Foreign Body

CPT-54120-PARTIAL-PENECTOMY-PENILE-RESECTION

CPT 54120: Partial Penectomy for Penile Injury or Disease

CPT-54125-TOTAL-PENECTOMY

CPT 54125: Total Penectomy for Serious Penile Injury or Disease

CPT-54135-RADICAL-PENECTOMY-BILATERAL-INGUINAL-LYMPHADENECTOMY

CPT 54135: Radical Penectomy with Bilateral Inguinal Lymphadenectomy

CPT-54150-CIRCUMCISION-CLAMP-DEVICE-WITH-REGIONAL-BLOCK

CPT 54150: Circumcision with Clamp or Device, Regional Penile Block

Showing 1–10 of 15

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Provider part of coordinated team (standard)	When the service is furnished under usual conditions without unusual services; often default for professional component when required by payer documentation.
`22`	Increased procedural services	When work, time, difficulty, or intensity substantially exceeds typical effort for `54130` (document justification).
`23`	Unusual anesthesia for procedure	When the procedure is performed under general anesthesia that is unusually hazardous for the patient due to medical condition.
`50`	Bilateral procedure	When a bilateral inguinal lymphadenectomy is performed in conjunction with penectomy and payer requires bilateral reporting.
`51`	Multiple procedures	When other distinct procedures are performed at the same session (for example, reconstruction, separate urologic procedures).
`52`	Reduced services	When the procedure is intentionally partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the operation is started but terminated due to extenuating circumstances or patient condition.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions of the operation (co-surgeons).
`66`	Surgical team approach	When a surgical team approach is required (e.g., complex reconstruction requiring multiple surgical specialties).
`78`	Unplanned return to OR following initial procedure	For an immediate postoperative return to the operating room for a related procedure during the global period.
`80`	Assistant surgeon	When an assistant surgeon participates and payer requires separate reporting for assistant fee.
`81`	Minimum assistant surgeon	When a minimal assistant role is documented and payer requires reporting.
`82`	Assistant surgeon (when qualified resident not available)	When a qualified resident is not available and an assistant surgeon is required.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist	When an advanced practice clinician performed substantive portion of the service under applicable state law and payer policy.

Taxonomy Code	Specialty	Notes
208000000X	Urology	Primary specialty performing radical penectomy and inguinal lymphadenectomy.
208600000X	Surgical Oncology	Often involved for complex oncologic resections and nodal management.
207XS0102X	General Surgery	May perform inguinal lymphadenectomy in conjunction with urology for complex cases.
363L00000X	Plastic Surgery	Often involved when reconstruction or perineal reconstruction is required after extensive resection.
2084P0800X	Radiation Oncology	Not procedural billing for surgery but part of multidisciplinary team for adjuvant planning; listed as associated specialty.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C60.0`	Malignant neoplasm of prepuce	Penile cancers of the foreskin that may require radical penectomy when extensive.
`C60.1`	Malignant neoplasm of glans penis	Tumors of the glans that can invade deeply and necessitate partial or total penectomy depending on extent; radical penectomy when extensive.
`C60.2`	Malignant neoplasm of body of penis	Primary site requiring resection; extensive disease may require `54130`.
`C60.9`	Malignant neoplasm of penis, unspecified	Used when specific subsite not documented but radical resection indicated.
`C77.1`	Secondary and unspecified malignant neoplasm of inguinal and femoral lymph nodes	Represents regional nodal metastasis prompting concurrent inguinal lymphadenectomy with penectomy.
`Z85.43`	Personal history of malignant neoplasm of penis	Relevant to surveillance and when considering salvage radical surgery for recurrent disease.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`54120`	Partial penectomy (removal of portion of penis)	Performed when tumor extent allows organ preservation; may be an alternative to `54130` for smaller lesions.
`38999`	Unlisted procedure, hemic node dissection or lymph node excision (if specific inguinal nodal codes not applicable)	Used to report atypical or extensive nodal dissections not described by standard codes; may be used adjunctively with penectomy when nodal work exceeds typical descriptors.
`38745`	Radical or modified radical bilateral inguinal lymphadenectomy	Commonly performed at same operative session for regional nodal clearance and staging; directly related to management of penile cancer.
`51960`	Perineal urethrostomy	Performed when urethral diversion is required after radical penectomy to establish a permanent urinary stoma.
`15734`	Muscle, myocutaneous or fasciocutaneous flap; trunk (includes pedicle or free flap)	Performed when reconstructive flap coverage is required for large defects after radical resection.

CPT 54100: Biopsy of Superficial Penile Skin Lesion, Diagnostic

CPT-54105-PENILE-BIOPSY-DEEP-SKIN-LESION

CPT 54105: Biopsy of Penis, Deep Skin Lesion

CPT-54110-PENILE-PLAQUE-EXCISION-PEYRONIES-DISEASE

CPT 54110: Penile Plaque Excision for Peyronie’s Disease

CPT-54111-EXCISION-PLAQUE-PENILE-SKIN-GRAFT-PEYRONIES-DISEASE

CPT 54111: Excision of Penile Plaque with Skin Graft for Peyronie’s Disease

CPT-54112-PENILE-PLA-QUE-EXCISION-SKIN-GRAFT

CPT 54112: Excision of Penile Plaque with Skin Graft >5 cm

CPT-54115-PENILE-IMPLANT-OR-DEEP-PENILE-FOREIGN-BODY-REMOVAL

CPT 54115: Removal of Penile Implant or Deep Penile Foreign Body

CPT-54120-PARTIAL-PENECTOMY-PENILE-RESECTION

CPT 54120: Partial Penectomy for Penile Injury or Disease

CPT-54125-TOTAL-PENECTOMY

CPT 54125: Total Penectomy for Serious Penile Injury or Disease

CPT-54135-RADICAL-PENECTOMY-BILATERAL-INGUINAL-LYMPHADENECTOMY

CPT 54135: Radical Penectomy with Bilateral Inguinal Lymphadenectomy

CPT-54150-CIRCUMCISION-CLAMP-DEVICE-WITH-REGIONAL-BLOCK

CPT 54150: Circumcision with Clamp or Device, Regional Penile Block

Showing 1–10 of 15

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 54130: Total Penectomy with Inguinal Lymphadenectomy

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Billing Code Overview

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CPT 54130: Total Penectomy with Inguinal Lymphadenectomy

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References