Summary & Overview
CPT 54240: Penile Plethysmography for Erectile Dysfunction Assessment
CPT code 54240 denotes penile plethysmography, a diagnostic procedure that records changes in penile circumference during erection using a mercury-filled plethysmograph to assess penile blood flow and aid evaluation of erectile dysfunction. The procedure has clinical relevance for urology and sexual medicine because it provides physiologic data that can help distinguish vascular causes of erectile dysfunction from other etiologies. Nationally, this code matters for coverage determinations, appropriate site-of-service billing, and integration into diagnostic pathways for sexual dysfunction.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service, and the kinds of benchmarks and policy considerations that influence coverage and billing practice. The publication outlines common billing modifiers and payer practices where available, summarizes clinical rationale for the service, and highlights areas where input data was not provided.
This summary is intended for a national audience of coding professionals, billing managers, and clinicians seeking concise guidance on the role and reporting of CPT code 54240 in diagnostic evaluation of erectile dysfunction. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 54240 describes a penile plethysmography procedure in which a flexible band filled with mercury (a plethysmograph) is placed around the penis to record changes in penile circumference during erection. The measurement is used to assess penile blood flow and evaluate erectile dysfunction.
Service type: Diagnostic vascular assessment / penile plethysmography
Typical site of service: Urology clinic or ambulatory diagnostic facility
Clinical & Coding Specifications
Clinical Context
A 56-year-old male presents to a urology clinic with a 9-month history of erectile dysfunction unresponsive to first-line oral phosphodiesterase-5 inhibitors. The urologist performs a focused history and physical exam, reviews medications and vascular risk factors (diabetes, smoking, hyperlipidemia), and orders nocturnal penile tumescence and rigity testing including penile plethysmography to evaluate hemodynamic causes. On the day of testing the patient is consented, asked to abstain from stimulants, and positioned in a private exam room. A flexible mercury-in-band plethysmograph is placed around the penile shaft and baseline circumference is recorded. Pharmacologic stimulation (e.g., intracavernosal injection of a vasodilator) may be administered according to clinic protocol, and the plethysmograph records changes in penile circumference over time to assess arterial inflow and veno-occlusive function. Results are reviewed by the urologist to differentiate neurogenic, arteriogenic, or venogenic erectile dysfunction and to guide further imaging, medical therapy, or referral for vascular intervention.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation separate from technical equipment and facility services. |
52 |