Summary & Overview
CPT 54440: Penile Repair, Reconstructive Plastic Surgery
CPT code 54440 designates surgical reconstruction of the penis to repair injury-related defects. This code is used when a plastic surgeon performs operative repair intended to restore anatomy and function after trauma, burns, or other injurious events. Nationally, accurate coding for penile reconstructive procedures affects access to appropriate surgical care, clinical documentation, and payment for complex urologic and plastic surgery services.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical service and typical sites of service, plus the typical payer mix considered in national analyses. The publication outlines benchmarking elements such as common billing practices, coding context for reconstructive penile surgery, and considerations for facility and surgeon settings. It also highlights policy and coverage themes relevant to reconstructive penile procedures, including the role of operative documentation and surgical setting in payer determinations.
This summary is intended for coding professionals, surgical practice managers, and policy analysts seeking a clear, national-level reference for CPT code 54440 and its clinical use in reconstructive penile surgery.
Billing Code Overview
CPT code 54440 covers plastic surgery repair of the penis performed to restore form and function after injury from various causes. The service involves reconstructive surgical techniques to repair traumatic or iatrogenic damage to penile tissues.
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Service type: Surgical, reconstructive plastic surgery
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 32-year-old male presents to the emergency department after a blunt traumatic crush injury to the penis sustained in a motor vehicle crash. He has lacerations of the penile shaft with partial disruption of the urethra and contusion of the glans. After initial trauma assessment, he is taken to the operating room for reconstruction. The surgical team performs debridement of devitalized tissue, tension-free repair of tunica albuginea and corporal bodies if needed, layered closure of penile skin, and urethral repair with catheterization for stenting. Postoperative care includes pain control, antibiotics, wound checks, and outpatient follow-up for wound healing and assessment of erectile or voiding function.
Typical site of service: hospital operating room or ambulatory surgery center depending on injury severity and inpatient status.
Service type: reconstructive plastic surgery of the penis to restore form and function following acute traumatic injury or surgical complication.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typically required (extensive debridement, complex reconstruction). |
23 |