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OBJECTIVE To characterize penile prosthesis surgery utilization and assess for regional differences in the use of this procedure across the United States. MATERIALS METHODS We examined penile prosthesis surgeries (inflatable and semi-rigid implants) in Medicare beneficiaries with ED for the years 2006 through 2014. Adjusted utilization rates were calculated per 1000 beneficiaries accounting for age and race. Utilization rates were examined nationally and by hospital referral region (HRR). RESULTS The national adjusted rate of penile prosthesis surgery