Summary & Overview
CPT 54417: Removal and Replacement of Penile Prosthesis with Debridement
CPT code 54417 denotes the surgical removal and same‑session replacement of a previously placed noninflatable semirigid or self‑contained inflatable penile prosthesis with required debridement and irrigation of infected tissue. This code captures a clinically complex urologic procedure that addresses prosthesis failure or infection and has implications for surgical resource use, postoperative care, and infection control nationally. Payors commonly engaged with this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context of the procedure, typical sites of service, and how the code is used to document operative management of infected or malfunctioning penile prostheses. The publication provides benchmarks and policy context relevant to surgical coding and payer coverage patterns, outlines common billing considerations, and highlights related clinical implications for infection management and device replacement. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 54417 describes the removal and immediate replacement of a previously placed noninflatable, semirigid or self‑contained, inflatable penile prosthesis during the same operative session. The service requires removal of the existing prosthesis and insertion of a replacement prosthesis, along with debridement and irrigation of infected tissue at the surgical site.
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Service type: Surgical procedure for prosthesis explantation and replacement with infection management
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Typical site of service: Operating room or hospital surgical suite (inpatient or outpatient surgical facility, as clinically indicated)
Data not available in the input for payers, associated taxonomies, ICD‑10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle‑aged to older man with a previously implanted penile prosthesis presenting with device malfunction or infection. The patient reports pain, erythema, drainage from the surgical site, device erosion, or recurrent mechanical failure. Preoperative evaluation includes history, targeted physical exam, urinalysis and urine culture, wound culture if drainage present, basic labs, and counseling about risks of device removal and same‑session replacement. The operative workflow includes induction of anesthesia (usually general or regional), explantation of the infected or malfunctioning noninflatable semirigid or inflatable prosthesis, debridement and copious irrigation of infected tissue and prosthesis capsule, sterile field re‑establishment, and insertion of a new prosthesis in the same operative session when clinically indicated. Postoperative care includes culture‑directed antibiotics, wound care, pain control, device education, and follow‑up for wound healing and device function. Typical site of service is an inpatient or ambulatory surgical center operating room depending on infection severity and patient comorbidities. The service type is a surgical operative procedure for removal and immediate replacement of a penile prosthesis with debridement for infection as described by 54417.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Not a real CMS modifier; listed input value only |