Penile implant cost and insurance coverage

In short: a penile implant is surgery, so the price looks like a surgery bill: a device, a facility, a surgeon and anesthesia. The clearest public numbers come from Medicare, which publishes national average payments for each procedure code. For most men the more useful question is what their own plan pays, and that depends heavily on the type of insurance. This page lays out the published figures, what moves them, and the questions that get you a real number before surgery.

Most men with ED never need one. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that most people with ED do not need surgery, and that an implant is something a man and his clinician may consider after other options have not helped (NIDDK, Treatment for ED). For what an implant is and how the types differ, start with our guide to penile implants; for the full range of options, see our overview of ED treatment options.

How much does a penile implant cost?

Using Medicare’s own 2026 data, the total approved amount for an inflatable penile implant averages about $18,700 in an ambulatory surgery center and about $21,900 in a hospital outpatient department. A semi-rigid (non-inflatable) implant averages about $11,500 and $14,000 in the same settings. With Original Medicare, the patient’s average share ranges from about $1,800 to $3,700, depending on the device and the setting (Medicare Procedure Price Lookup).

Sources: Medicare Procedure Price Lookup for codes 54405, 54400 and 54410, national averages based on Medicare’s 2026 payments and copayments, checked 2026-10-17.

Three cautions keep these numbers honest. They are national averages, and Medicare says costs may vary by location. They are what Medicare pays, which is not the same as a hospital’s list price or what a private insurer has negotiated. And Medicare notes that a procedure may involve more than one doctor, so additional costs may apply (Medicare Procedure Price Lookup). We have not found a published, reliable cash price for the US, so this page does not offer one.

What drives the cost of penile implant surgery?

Four things move the total most: the type of device, where the surgery is done, the professionals involved, and whether it is a first implant or a revision. The Medicare figures above show the first two clearly. An inflatable implant has a higher approved total than a semi-rigid one, and the facility fee, not the surgeon’s fee, makes up most of the bill: for an inflatable implant in a surgery center, Medicare lists a $728 doctor fee against an $18,018 facility fee (Medicare, code 54405).

A “charge” and a “payment” are different numbers. The review’s facility charges are what facilities billed; Medicare’s figures are what Medicare approved. Neither is your bill. Your share depends on your plan’s deductible, coinsurance and any out-of-pocket maximum, which is why the questions near the end of this page matter.

Does Medicare cover penile implants?

Yes, Original Medicare can pay for an implant when it is a reasonable and necessary treatment for ED. Medicare’s national coverage determination on impotence says that “program payment may be made for diagnosis and treatment of sexual impotence” and names implantation of a penile prosthesis as an example of surgical treatment (CMS, NCD 230.4). The same policy says that if abuse is suspected, Medicare may ask for documentation that a treatment was appropriate in individual cases.

With Original Medicare, Medicare generally pays 80% of the approved amount and the patient pays 20%. In a hospital outpatient department, Original Medicare caps the copayment at $1,676 in 2026, a cap Medicare says likely applies to implant surgery (Medicare, code 54405). A supplemental insurance policy may cover some of the remaining cost, and people with a Medicare Advantage plan are told to check costs with the plan itself.

In one large coverage database, 98.7% of Original Medicare patients and 97.1% of Medicare Advantage patients seeking a penile implant in 2021 were approved or verified for coverage (Khera et al., Urology Practice, 2023). That study used a device maker’s records, and three of its authors were employees of that company when the study was done, so it describes the men whose surgeons asked for a benefit check rather than all men.

Does private insurance cover penile implants?

Often, but less consistently than Medicare, and the main reason is the plan’s own exclusions. In the same data, about 80% of all patients were approved or verified for coverage in each year from 2019 to 2021, and in 2021 the rate for those with commercial insurance was 75.0% (Khera et al., 2023). The most common reason for no coverage was an employer exclusion, which rose from 13.5% of patients in 2019 to 17.5% in 2021.

Employer-sponsored plans stood out. Among 3,083 patients with plans chosen by an employer, from 2018 to 2021, 63.1% were approved or verified, and 34.2% had no coverage because the plan excluded the implant (Khera et al., 2023). In 2021, coverage among commercial plan types also varied, from 68.8% in PPO plans to 34.4% in open access plus plans. An exclusion is written into the plan, so it is different from a denial because a plan judged the surgery not medically necessary. The study’s authors describe the appeal process for implant coverage as challenging, and say prior authorization and help from the manufacturer’s benefit verification service may make coverage more likely (Khera et al., 2023).

Source: Khera et al., Urology Practice, 2023, from one manufacturer’s benefit verification records. These are approval rates in that database, not a promise about any one plan.

Does Medicaid cover penile implants?

It depends on the state. A 2021 review of public Medicaid physician fee schedules could read the schedules for 49 of 50 states and found that 28 listed coverage for at least one type of implant (Barnard et al., J Sex Med, 2021). Eleven of those states documented a prior authorization requirement, and no fee schedule clearly stated the criteria for approval. Because Medicaid rules change, the state Medicaid office or the urologist’s billing staff is the place to confirm current coverage.

How does implant cost compare with other ED treatments?

An implant costs more up front, while pills are an ongoing expense. A 2026 review in Current Urology Reports describes implant surgery as the most cost-effective treatment for ED after pills have failed, measured by quality of life, and cites one analysis in which a lifetime of PDE5 inhibitor pills cost over $15,000 more than surgery (Black et al., 2026). Those are estimates for groups of men, so they say little about any one man’s costs.

Coverage also differs by treatment. Vacuum erection devices, for example, have been excluded from Medicare coverage by law since July 1, 2015 (CMS, Vacuum Erection Devices policy article A52712). For what pills cost, see our breakdown of online ED treatment cost. Men who are weighing an implant after prostate cancer treatment may also find our guide to ED after prostate treatment useful.

What should you ask the surgeon’s office before surgery?

Ask for a benefit check and a written estimate before you book. In the manufacturer database described above, a benefit check recorded ahead of time whether the plan covered the procedure, excluded it, or approved a prior authorization (Khera et al., 2023). These questions cover the gaps the sources point to:

1. Has my plan been checked for this exact procedure? Ask which billing code will be used (for example, 54405 for a three-piece inflatable implant) and whether the plan excludes implants outright.
2. Is prior authorization needed, and who files it? Some plans use it (Khera et al., 2023), and 11 of the 28 state Medicaid fee schedules that listed coverage documented a requirement (Barnard et al., 2021).
3. Where will the surgery be done? A surgery center and a hospital outpatient department have different approved totals and patient shares under Medicare (Medicare Procedure Price Lookup).
4. Which bills will I get? Ask whether the estimate includes the facility, the surgeon, anesthesia and the device, or whether some arrive separately.
5. What happens to cost if the device needs revision? Replacement is billed as its own procedure (Medicare, code 54410).
6. If coverage is denied, why? A plan exclusion and a medical-necessity denial need different next steps.

For what the operation and the weeks after it involve, see penile implant surgery and recovery. Our page on how ED is diagnosed explains the workup a urologist usually does first, and the notes from that workup are what an insurer reviews.

These points come from the introduction and guideline statements 18, 19 and 20 of the AUA erectile dysfunction guideline (2018), which also makes shared decision-making the cornerstone of ED care.

Sources

Every figure on this page comes from the sources below. Medicare figures are 2026 national averages and were checked on 2026-10-17; your own costs will differ.

1. Diagnosis and Treatment of Impotence, National Coverage Determination 230.4, Centers for Medicare & Medicaid Services
2. Procedure Price Lookup, code 54405: insertion of multi-component inflatable penile prosthesis, Medicare.gov
3. Procedure Price Lookup, code 54400: insertion of non-inflatable (semi-rigid) penile prosthesis, Medicare.gov
4. Procedure Price Lookup, code 54410: removal and replacement of an inflatable penile prosthesis, Medicare.gov
5. Khera M, et al. Implantable Penile Prosthesis for Erectile Dysfunction: Insurance Coverage in the United States. Urology Practice, 2023 (data from a manufacturer’s benefit verification databases; several authors are employees of that manufacturer)
6. Barnard JT, Grimaud L, Yafi FA. Does Medicaid Cover Penile Prosthesis Surgery? A State-by-State Analysis. J Sex Med, 2021;18:1455-1460
7. Black K, et al. Cost Considerations in Penile Implant Surgery from a Global Perspective. Current Urology Reports, 2026
8. Vacuum Erection Devices (VED), Policy Article A52712, Centers for Medicare & Medicaid Services
9. Erectile Dysfunction: AUA Guideline (2018), American Urological Association
10. Treatment for Erectile Dysfunction, National Institute of Diabetes and Digestive and Kidney Diseases