Summary & Overview

HCPCS C2622: Prosthesis, Penile, Non-Inflatable

HCPCS Level II code C2622 denotes a non-inflatable penile prosthesis used in surgical management of erectile dysfunction. This durable implant is a distinct category of penile prosthesis that does not include inflatable components; reimbursement and coverage policies for prosthetic devices have implications for access to sexual health interventions and surgical urology services nationwide. The code matters because payers and facilities use it to classify device billing separately from surgical procedure codes, affecting claims processing and device reporting.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what the code represents, common clinical contexts for use, and the typical sites of service for implantation. The publication summarizes typical modifier use and payer considerations when available, and describes how this code interacts with surgical service lines and facility billing. It also identifies gaps where data was not provided and indicates where further payer-specific policy details would be needed for coding and coverage determinations.

This national summary is intended for coding managers, billing teams, policy analysts, and clinicians seeking a concise reference to the clinical role and billing classification of HCPCS Level II code C2622.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareC2622HCPCSpenile-prosthesisurologysurgical-implantmedical-deviceambulatory-surgeryhospital-billing

Billing Code Overview

HCPCS Level II code C2622 represents a prosthesis, penile, non-inflatable. This device is a surgically implanted, non-inflatable penile prosthesis used to treat erectile dysfunction when other treatments are ineffective or unsuitable. The service type associated with this code is the provision and implantation of a non-inflatable penile prosthesis. The typical site of service is an inpatient or outpatient surgical setting, including hospital operating rooms or ambulatory surgical centers, where urologic implant procedures are performed.

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Clinical & Coding Specifications

Clinical Context

A male patient with organic erectile dysfunction who has failed or is intolerant of oral, intracavernosal, or vacuum therapies presents for implantation of a non-inflatable (malleable) penile prosthesis. Typical patients are older men with neurogenic erectile dysfunction (for example, following radical pelvic surgery or spinal cord injury), severe vascular disease, or Peyronie disease with refractory erectile dysfunction. The clinical workflow begins with preoperative evaluation by a urologist including history, physical exam, and review of prior treatments and comorbidities. Appropriate counseling and informed consent are completed, including device type, risks, and expected outcomes. Preoperative optimization addresses diabetes control, smoking cessation, and infection risk. On the day of service the procedure is performed in an operating room or ambulatory surgery center under general, regional, or monitored anesthesia care. The surgeon implants a C2622 non-inflatable penile prosthesis (malleable rods) via a penoscrotal or infrapubic approach; placement typically includes corporal dilation, device sizing, and placement of paired malleable rods. Intraoperative documentation includes laterality (paired device), approach, device model/catalog number, irrigation and antibiotic use, and any intraoperative complications. Postoperative management includes short-term antibiotics per facility protocol, wound care instructions, activity restrictions, and follow-up visits to assess healing, device position, and function. Billing uses HCPCS C2622 for the prosthesis supply; operative and anesthesia professional services are reported separately with applicable CPT and anesthesia codes and appropriate modifiers to indicate circumstances such as bilateral procedure, unusual procedural service, or specific payment/ownership indicators.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or time substantially exceeds typical for implant procedure and documentation supports increased effort.
`52`	Reduced services	Use when the procedure is partially completed or scope is reduced and documentation supports less than standard service.
`53`	Discontinued procedure	Use when procedure is started but terminated due to extenuating circumstances before completion.
`54`	Surgical care only	Use for billing when another provider bills postoperative care separately.
`55`	Postoperative management only	Use when billing only for post-op care after another surgeon performed the operation.
`56`	Preoperative management only	Use when only preoperative management is billed by one surgeon and another performs the surgery.
`62`	Two surgeons	Use when two surgeons of different specialties are required and both active in the procedure.
`AS`	Ambulatory surgery	Use to indicate the service performed at an ambulatory surgical center when required by payor rules.
`NU`	New equipment, purchase	Use to indicate a new prosthetic device is provided (ownership/purchase indicator on some payor forms).
`QX`	Modifier for Qualified Non-physician	Use when a qualified non-physician practitioner performs part of services under applicable rules.
`QK`	Medical direction of 2–4 CRNAs	Use when physician provides medical direction of multiple CRNAs during anesthesia for the case.
`QY`	Medical direction of one CRNA	Use when physician medically directs one CRNA.
`RR`	Registered nurse anesthetist	Use to indicate services personally performed by a CRNA when applicable.
`FX`	Procedure requires a device replacement or fixation	Use when coding needs to indicate fixation or replacement context for the prosthesis.
`TG`	Left hand, finger, or side modifiers analogous (used per payor)	Use when laterality or specific side designators are required by payor (if applicable).

Taxonomy Code	Specialty	Notes
`207VC0000X`	Urology	Primary specialty that performs penile prosthesis implantation.
`2084P0800X`	Prosthetics and Orthotics	Device suppliers and vendors involved in prosthesis provision and documentation for `NU`/ownership reporting.
`363L00000X`	Anesthesiology	Anesthesia providers who deliver general, regional, or monitored anesthesia care for the procedure.
`207L00000X`	Surgery (General)	General surgeons may be co-surgeons in complex pelvic reconstruction cases involving penile prosthesis.
`163W00000X`	Infectious Disease	Consultants for complex patients with infection risk or device-related infections.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N52.9`	Male erectile dysfunction, unspecified	Primary indication for penile prosthesis implantation when other therapies have failed.
`N48.5`	Peyronie disease	Associated condition causing penile curvature and erectile dysfunction prompting prosthesis placement in refractory cases.
`G82.50`	Paraplegia, unspecified	Neurogenic causes of erectile dysfunction (spinal cord injury) where prosthesis may be indicated for persistent dysfunction.
`E11.9`	Type 2 diabetes mellitus without complications	Diabetes is a common comorbidity associated with vascular erectile dysfunction and higher infection risk around implantation.
`Z95.0`	Presence of cardiac pacemaker and defibrillator	Example comorbidity impacting perioperative management; patients with implantable devices may require special perioperative planning.
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Example code template for device-related infection when prosthesis infection presents; use specific code for penile prosthesis infection when available and supported.
`Z48.812`	Encounter for surgical wound closure following procedure on external genitalia	Postoperative care or related encounters after penile prosthesis surgery.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`54400`	Insertion of penile prosthesis; non-inflatable (malleable)	Primary CPT code describing surgical implantation of a non-inflatable penile prosthesis; reports the operative service.
`54050`	Removal of penile and scrotal skin; partial or total penectomy (when applicable)	May be necessary in extensive penile disease or prior operative history requiring tissue management before prosthesis implantation.
`54405`	Removal and replacement of infected or malfunctioning penile prosthesis, non-inflatable	Used when explantation and immediate or staged replacement are performed for infected or malfunctioning devices.
`20680`	Removal of implant; deep (e.g., knee, shoulder) — site-specific; comparable for device removal coding when explantation required (note: use appropriate site-specific removal codes per payer)	Used in cases requiring removal of malleable rods when infection or mechanical failure mandates explantation.
`99024`	Postoperative follow-up visit, typically global period	Used to report postoperative evaluation and management visits within the global surgical period when applicable.