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CPT code 54160: Circumcision, neonate, surgical excision2026 Medicare rate & RVUs in Washington, DC area

Reports surgical removal of a newborn’s foreskin when the circumcision is performed by excision rather than with a clamp, device, or dorsal slit.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Washington, DC area, Medicare pays $258.18 for 54160 in the office and $144.86 when it’s performed in a hospital or facility.

$258.18Office (non-facility)
$144.86Hospital or facility
+13.0%vs the national office rate ($228.46)

Check a contract rate as a % of Medicare · 54160 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 54160 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 54160 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 54160 covers

This code covers circumcision of a neonate by surgical excision of the foreskin, rather than using a clamp or other device or performing a dorsal slit. It is typically performed by a physician such as a pediatrician, family physician, or urologist in a hospital nursery or outpatient setting. The operative approach, not simply the fact that a circumcision occurred, distinguishes this service from circumcision codes for other techniques or age groups.

Select the code based on the patient’s age and the documented method. The record should identify the neonate’s age and describe the excision technique. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. CMS does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 54160

Across 109 of 109 payment localities, the office rate for 54160 runs from $204.09 in Arkansas to $292.07 in San Benito County, CA. Washington, DC area pays $258.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

54160 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$258.18
  2. Los Angeles, CA · California$252.84−$5.34
  3. Miami, FL · Florida$250.85−$7.33
  4. Chicago, IL · Illinois$243.99−$14.19
  5. Manhattan, NY · New York$262.06+$3.88
  6. Alaska · Alaska$273.53+$15.35
  7. Alabama · Alabama$206.81−$51.37

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

54160 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$204.09$121.46
ArizonaArizona$222.69$129.48
Bakersfield, CACalifornia$238.67$133.24
Chico, CACalifornia$237.70$132.28
El Centro, CACalifornia$237.76$132.33
Fresno, CACalifornia$237.70$132.28
Hanford, CACalifornia$237.70$132.28
Madera, CACalifornia$237.70$132.28

54160 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$204.09

$273.53

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
54160 office rate range by state
State / territoryOffice rate rangeLocalities
AK$273.531
AL$206.811
AR$204.091
AZ$222.691
CA$237.70–$292.0729
CO$235.671
CT$242.821
DC$258.181
DE$226.141
FL$228.07–$250.853
GA$216.00–$233.082
GU$242.311
HI$242.311
IA$210.351
ID$211.861
IL$222.93–$243.994
IN$212.951
KS$210.041
KY$212.551
LA$212.48–$222.002
MA$234.70–$256.812
MD$230.00–$258.183
ME$213.50–$223.182
MI$218.14–$231.302
MN$224.621
MO$209.55–$222.013
MS$206.831
MT$228.441
NC$215.441
ND$221.911
NE$211.221
NH$232.621
NJ$245.25–$256.002
NM$219.481
NV$226.761
NY$218.44–$268.695
OH$216.811
OK$211.571
OR$224.65–$241.942
PA$216.79–$237.612
PR$229.781
RI$233.291
SC$216.551
SD$221.141
TN$211.081
TX$215.54–$235.208
UT$219.241
VA$222.93–$258.182
VI$229.781
VT$221.671
WA$234.05–$261.202
WI$215.171
WV$215.541
WY$225.601

See 54160 in every payment locality

How the 54160 rate is calculated

Each of 54160’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 54160

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.47

2.47 RVUs× 1.000 GPCI

Practice expense4.04

4.04 RVUs× 1.000 GPCI

Malpractice0.33

0.33 RVUs× 1.000 GPCI

Adjusted RVUs

6.8400

Conversion factor

$33.4009

Medicare rate

$228.46

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,255

Code
54160
Physician work
2.47
Practice expense
4.04
Malpractice
0.33

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 54160 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.47× 1.0542.6034
Practice expense4.04× 1.1784.7591
Malpractice0.33× 1.1130.3673
Total RVUs7.7298
Conversion factor× 33.4009

Office rate, Washington, DC area$258.18

Office: (2.47 × 1.054 + 4.04 × 1.178 + 0.33 × 1.113) × $33.4009 = $258.18

Facility: (2.47 × 1.054 + 1.16 × 1.178 + 0.33 × 1.113) × $33.4009 = $144.86

Open 54160 in the RVU calculator

Payment rules and modifiers for 54160

54160 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54160

Circumcision, neonate, surgical excision

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 54160

Circumcision, neonate, surgical excision

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

54160 without 51 · national office

$228.46

Circumcision, neonate, surgical excision

54160-51 · Second procedure: 50%

$114.23

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 54160

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 54160
CodeHow it relatesOffice range, Washington, DC area
Used instead
54150Circumcision, device with regional blockCircumcision using a clamp or other device with a regional block, rather than surgical excision.$170.84
Same family
54161Circumcision, age 28 days or olderSurgical-excision circumcision for the older age category.No office rate
Often billed with
54164Frenulotomy, penile frenulumPenile frenulotomy may be reported when a distinct frenulum release is also performed and documented.No office rate

How 54160 has changed in Washington, DC area

54160 · Office / nonfacility

$258.18

Effective 2026-10-01

The base rate is $13.82 higher than on 2025-10-01, moving from $244.36 to $258.18 (5.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $244.36changed to$258.18

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.53 changed to 2.47
    • Practice expense RVU 3.81 changed to 4.04
    • Malpractice RVU 0.29 changed to 0.33
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $252.64changed to$244.36

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.82 changed to 3.81
    • Malpractice RVU 0.31 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $248.52changed to$252.64

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $256.91changed to$248.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.74 changed to 3.82
    • Malpractice RVU 0.30 changed to 0.31
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $263.96changed to$256.91

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.71 changed to 3.74
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $267.42changed to$263.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.75 changed to 3.71
    • Malpractice RVU 0.28 changed to 0.29

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $262.03changed to$267.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.48 changed to 3.75
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $260.42changed to$262.03

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.52 changed to 3.48
    • Malpractice RVU 0.27 changed to 0.28
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $261.00changed to$260.42

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.54 changed to 3.52

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $257.99changed to$261.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.47 changed to 3.54
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $260.39changed to$257.99

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.51 changed to 3.47
    • Malpractice RVU 0.30 changed to 0.28
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $256.97changed to$260.39

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.42 changed to 3.51
    • Malpractice RVU 0.29 changed to 0.30

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $255.69changed to$256.97

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $250.63changed to$255.69

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.38 changed to 3.42
    • Malpractice RVU 0.23 changed to 0.29
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $248.30changed to$250.63

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.65 changed to 3.38
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $248.30

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$258.18$144.86RVU26D
2026-07-01$258.18$144.86RVU26C
2026-04-01$258.18$144.86RVU26B
2026-01-01$258.18$144.86RVU26A
2025-10-01$244.36$157.22RVU25D
2025-07-01$244.36$157.22RVU25C
2025-04-01$244.36$157.22RVU25B
2025-01-01$244.36$157.22RVU25A
2024-10-01$252.64$161.38RVU24D
2024-07-01$252.64$161.38RVU24C
2024-04-01$252.64$161.38RVU24B
2024-03-09$252.64$161.38RVU24AR
2024-01-01$248.52$158.75RVU24A
2023-10-01$256.91$163.52RVU23D
2023-07-01$256.91$163.52RVU23C
2023-04-01$256.91$163.52RVU23B
2023-01-01$256.91$163.52RVU23A
2022-10-01$263.96$166.43RVU22D
2022-07-01$263.96$166.43RVU22C
2022-04-01$263.96$166.43RVU22B
2022-01-01$263.96$166.43RVU22A
2021-10-01$267.42$166.93RVU21D
2021-07-01$267.42$166.93RVU21C
2021-04-01$267.42$166.93RVU21B
2021-01-01$267.42$166.93RVU21A
2020-10-01$262.03$168.61RVU20D
2020-07-01$262.03$168.61RVU20C
2020-04-01$262.03$168.61RVU20B
2020-01-01$262.03$168.61RVU20A
2019-10-01$260.42$167.05RVU19D
2019-07-01$260.42$167.05RVU19C
2019-04-01$260.42$167.05RVU19B
2019-01-01$260.42$167.05RVU19A
2018-10-01$261.00$166.43RVU18D
2018-07-01$261.00$166.43RVU18C
2018-04-01$261.00$166.43RVU18B
2018-01-01$261.00$166.43RVU18AR1
2017-10-01$257.99$166.31RVU17D
2017-07-01$257.99$166.31RVU17C
2017-04-01$257.99$166.31RVU17B
2017-01-01$257.99$166.31RVU17A
2016-10-01$260.39$167.63RVU16D
2016-07-01$260.39$167.63RVU16C
2016-04-01$260.39$167.63RVU16B
2016-01-01$260.39$167.63RVU16A
2015-10-01$256.97$166.04RVU15D
2015-07-01$256.97$166.04RVU15C
2015-04-01$255.69$165.22RVU15B
2015-01-01$255.69$165.22RVU15A
2014-10-01$250.63$161.93RVU14D
2014-07-01$250.63$161.93RVU14C
2014-04-01$250.63$161.93RVU14B
2014-01-01$250.63$161.93RVU14A
2013-10-01$248.30$156.18RVU13D
2013-07-01$248.30$156.18RVU13C
2013-04-01$248.30$156.18RVU13B
2013-01-01$248.30$156.18RVU13AR

Price 54160 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

54160 billing questions

How does this differ from 54150?

54160 is for neonatal circumcision by surgical excision. 54150 describes circumcision using a clamp or other device with a regional block.

When should 54161 be considered instead?

Use 54161 for surgical-excision circumcision in the older age category. Document the patient’s age because age separates these sibling codes.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in 54160.

Can modifier 50 be appended?

No. Modifier 50 is inappropriate for this circumcision service.

Can an assistant or co-surgeon be billed?

CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What documentation supports 54160 rather than a neighboring circumcision code?

Document the neonate’s age and that the foreskin was removed by surgical excision. The record should make clear that the service was not performed with a clamp or other device or by dorsal slit.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 54160PPRRVU2026_Oct_nonQPP.csv, line 6,255 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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