CPT code 54161: Circumcision, age 28 days or older2026 Medicare rate & RVUs in Texas
Reports surgical removal of the foreskin in a patient aged 28 days or older, using an excisional technique rather than a clamp or device.
CMS doesn’t publish an office rate for 54161 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 54161 covers
This code is for circumcision performed by surgically excising the foreskin in a patient who is at least 28 days old. Urologists, pediatric surgeons, and other surgeons may perform it in an office procedure room or an operating room. Common clinical reasons include phimosis or recurrent inflammation of the foreskin; the record should identify the indication and the excisional approach.
Choose this code by the patient’s age and the method used, not simply by the fact that circumcision was performed. Document the age, indication, and operative work. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate for this procedure. Assistant-at-surgery services are not paid; 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.
Where 54161 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $183.06 |
| Beaumont, TX | Unavailable | $174.75 |
| Brazoria, TX | Unavailable | $178.28 |
| Dallas, TX | Unavailable | $179.78 |
| Fort Worth, TX | Unavailable | $179.37 |
| Galveston, TX | Unavailable | $179.07 |
| Houston, TX | Unavailable | $186.76 |
| Rest of Texas | Unavailable | $176.67 |
How the 54161 rate is calculated
Each of 54161’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 · 54161
RVUs × geographic indexes × conversion factor
Work3.24
3.24 RVUs× 1.000 GPCI
Practice expense1.76
1.76 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
5.4200
Conversion factor
$33.4009
Medicare rate
$181.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54161
54161 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54161
Circumcision, age 28 days or older
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54161
Circumcision, age 28 days or older
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54161 without 51 · national facility
$181.03
Circumcision, age 28 days or older
54161-51 · Second procedure: 50%
$90.52
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%).
54161 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 54160CircumcisionNeonate, surgical excision
- Both describe excisional circumcision; select 54160 for a newborn younger than 28 days and 54161 at 28 days or older.
- 54150CircumcisionDevice with regional block
- This code is for a clamp- or device-based method with a regional penile block, rather than the excisional method reported with 54161.
- 54163Circumcision repairRevision after prior circumcision
- Code 54163 concerns repair of a prior circumcision, not the initial excisional removal of foreskin reported with 54161.
54161 billing questions
How does this differ from circumcision code 54160?
Code 54161 is for excisional circumcision at age 28 days or older. Code 54160 is the excisional circumcision code for a newborn younger than 28 days.
When should 54150 be considered instead?
Code 54150 describes circumcision using a clamp or other device with a regional penile block. Use 54161 when the documented method is surgical excision in a patient at least 28 days old.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are paid at 50% under the standard multiple procedure reduction.
Can modifier 50 or an assistant-at-surgery service be reported?
Modifier 50 is inappropriate for this procedure. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
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
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