CPT code 54162: Penile adhesion lysis, post-circumcision adhesions2026 Medicare rate & RVUs in Austin, TX
Reports release or excision of adhesions between penile skin and the glans after circumcision, commonly performed in an office or outpatient setting.
In Austin, TX, Medicare pays $271.05 for 54162 in the office and $186.59 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 54162 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 54162 covers
This service releases or removes penile adhesions that have formed after circumcision, separating skin attached to the glans. Urologists and other clinicians who perform penile procedures may treat these adhesions in an office or outpatient setting. The operative target is the adhesion itself, rather than a new circumcision, repair of an incomplete circumcision, or release of the frenulum.
Report the code when the documented procedure is lysis or excision of post-circumcision penile adhesions. The record should identify the adhesions and describe the release or removal performed. The service has 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 multiple-procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, 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 Austin, TX compares for 54162
Across 109 of 109 payment localities, the office rate for 54162 runs from $237.38 in Arkansas to $332.34 in San Benito County, CA. Austin, TX pays $271.05. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Austin, TX · this page$271.05
- Beaumont, TX · Texas$250.43−$20.62
- Brazoria, TX · Texas$260.70−$10.35
- Dallas, TX · Texas$262.62−$8.43
- Fort Worth, TX · Texas$261.38−$9.67
- Galveston, TX · Texas$261.66−$9.39
- Houston, TX · Texas$269.35−$1.70
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $255.60 | $179.84 |
| Los Angeles, CACalifornia | $289.90 | $195.47 |
| Washington, DC areaDistrict of Columbia | $296.90 | $202.86 |
| Miami, FLFlorida | $291.47 | $208.37 |
| Chicago, ILIllinois | $283.84 | $203.61 |
| Manhattan, NYNew York | $302.34 | $209.58 |
| AlaskaAlaska | $321.24 | $236.22 |
| AlabamaAlabama | $240.37 | $170.52 |
| ArkansasArkansas | $237.38 | $168.81 |
| ArizonaArizona | $257.78 | $180.43 |
| Bakersfield, CACalifornia | $274.40 | $186.91 |
| Chico, CACalifornia | $273.16 | $185.67 |
| El Centro, CACalifornia | $273.23 | $185.74 |
| Fresno, CACalifornia | $273.16 | $185.67 |
| Hanford, CACalifornia | $273.16 | $185.67 |
| Madera, CACalifornia | $273.16 | $185.67 |
| Merced, CACalifornia | $273.16 | $185.67 |
| Modesto, CACalifornia | $273.16 | $185.67 |
| Napa, CACalifornia | $309.26 | $204.04 |
| Oxnard, CACalifornia | $287.78 | $193.42 |
| Redding, CACalifornia | $273.16 | $185.67 |
| Rest of CaliforniaCalifornia | $273.16 | $185.67 |
| Riverside, CACalifornia | $277.71 | $190.22 |
| Sacramento, CACalifornia | $284.73 | $191.89 |
| Salinas, CACalifornia | $283.62 | $191.10 |
| San Diego, CACalifornia | $288.85 | $193.37 |
| Marin County, CACalifornia | $325.09 | $212.54 |
| San Francisco, CACalifornia | $324.62 | $212.06 |
| San Benito County, CACalifornia | $332.34 | $217.23 |
| Santa Clara County, CACalifornia | $330.39 | $215.28 |
| San Luis Obispo, CACalifornia | $279.26 | $188.34 |
| Santa Cruz, CACalifornia | $290.48 | $193.49 |
| Santa Maria, CACalifornia | $284.29 | $191.21 |
| Santa Rosa, CACalifornia | $293.30 | $195.28 |
| Stockton, CACalifornia | $273.16 | $185.67 |
| Vallejo, CACalifornia | $308.57 | $203.36 |
| Visalia, CACalifornia | $273.16 | $185.67 |
| Yuba City, CACalifornia | $273.16 | $185.67 |
| ColoradoColorado | $271.51 | $186.58 |
| ConnecticutConnecticut | $280.24 | $194.27 |
| DelawareDelaware | $261.62 | $182.75 |
| Fort Lauderdale, FLFlorida | $277.38 | $196.52 |
| Rest of FloridaFlorida | $265.01 | $188.70 |
| Atlanta, GAGeorgia | $269.62 | $188.51 |
| Rest of GeorgiaGeorgia | $251.56 | $180.36 |
| Hawaii, Guam, HIHawaii | $277.74 | $186.98 |
| IowaIowa | $243.68 | $170.63 |
| IdahoIdaho | $245.45 | $172.01 |
| East St. Louis, ILIllinois | $267.07 | $193.63 |
| Rest of IllinoisIllinois | $259.75 | $186.87 |
| Suburban Chicago, ILIllinois | $279.62 | $197.64 |
| IndianaIndiana | $246.63 | $172.63 |
| KansasKansas | $243.62 | $171.45 |
| KentuckyKentucky | $247.25 | $176.28 |
| New Orleans, LALouisiana | $257.73 | $182.62 |
| Rest of LouisianaLouisiana | $247.29 | $176.64 |
| Metropolitan Boston, MAMassachusetts | $294.63 | $199.32 |
| Rest of MassachusettsMassachusetts | $270.61 | $186.55 |
| Baltimore area, MDMaryland | $279.62 | $193.96 |
| Rest of MarylandMaryland | $265.84 | $185.05 |
| Rest of MaineMaine | $247.54 | $174.10 |
| Southern Maine, MEMaine | $257.75 | $178.64 |
| Detroit, MIMichigan | $268.86 | $191.82 |
| Rest of MichiganMichigan | $253.66 | $180.78 |
| MinnesotaMinnesota | $258.44 | $176.30 |
| Metropolitan Kansas City, MOMissouri | $255.22 | $180.26 |
| Metropolitan St. Louis, MOMissouri | $257.42 | $181.42 |
| Rest of MissouriMissouri | $244.25 | $175.43 |
| MississippiMississippi | $240.81 | $172.08 |
| MontanaMontana | $264.17 | $184.34 |
| North CarolinaNorth Carolina | $249.63 | $175.15 |
| North DakotaNorth Dakota | $255.87 | $176.04 |
| NebraskaNebraska | $244.55 | $170.86 |
| New HampshireNew Hampshire | $268.27 | $185.17 |
| Northern New JerseyNew Jersey | $294.69 | $202.08 |
| Rest of New JerseyNew Jersey | $282.95 | $195.78 |
| New MexicoNew Mexico | $255.24 | $182.04 |
| NevadaNevada | $262.00 | $182.09 |
| NYC suburbs and Long Island, NYNew York | $309.98 | $215.06 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $285.50 | $198.09 |
| Queens, NYNew York | $303.16 | $208.81 |
| Rest of New YorkNew York | $252.94 | $177.10 |
| OhioOhio | $251.96 | $179.08 |
| OklahomaOklahoma | $245.88 | $174.60 |
| Portland, OROregon | $278.10 | $189.41 |
| Rest of OregonOregon | $259.47 | $179.96 |
| Metropolitan Philadelphia, PAPennsylvania | $274.68 | $191.58 |
| Rest of PennsylvaniaPennsylvania | $251.79 | $178.51 |
| Puerto RicoPuerto Rico | $265.55 | $184.85 |
| Rhode IslandRhode Island | $269.43 | $186.96 |
| South CarolinaSouth Carolina | $251.31 | $177.55 |
| South DakotaSouth Dakota | $254.89 | $175.06 |
| TennesseeTennessee | $244.79 | $172.22 |
| UtahUtah | $254.25 | $179.21 |
| VirginiaVirginia | $257.66 | $179.19 |
| Virgin Islands, VIUnited States Virgin Islands | $265.55 | $184.85 |
| VermontVermont | $255.85 | $176.82 |
| Rest of WashingtonWashington | $269.78 | $185.72 |
| King County, WAWashington | $299.27 | $201.32 |
| WisconsinWisconsin | $248.53 | $172.06 |
| West VirginiaWest Virginia | $251.65 | $182.28 |
| WyomingWyoming | $260.55 | $180.73 |
54162 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$237.38
$321.24
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $321.24 | 1 |
| AL | $240.37 | 1 |
| AR | $237.38 | 1 |
| AZ | $257.78 | 1 |
| CA | $273.16–$332.34 | 29 |
| CO | $271.51 | 1 |
| CT | $280.24 | 1 |
| DC | $296.90 | 1 |
| DE | $261.62 | 1 |
| FL | $265.01–$291.47 | 3 |
| GA | $251.56–$269.62 | 2 |
| GU | $277.74 | 1 |
| HI | $277.74 | 1 |
| IA | $243.68 | 1 |
| ID | $245.45 | 1 |
| IL | $259.75–$283.84 | 4 |
| IN | $246.63 | 1 |
| KS | $243.62 | 1 |
| KY | $247.25 | 1 |
| LA | $247.29–$257.73 | 2 |
| MA | $270.61–$294.63 | 2 |
| MD | $265.84–$296.90 | 3 |
| ME | $247.54–$257.75 | 2 |
| MI | $253.66–$268.86 | 2 |
| MN | $258.44 | 1 |
| MO | $244.25–$257.42 | 3 |
| MS | $240.81 | 1 |
| MT | $264.17 | 1 |
| NC | $249.63 | 1 |
| ND | $255.87 | 1 |
| NE | $244.55 | 1 |
| NH | $268.27 | 1 |
| NJ | $282.95–$294.69 | 2 |
| NM | $255.24 | 1 |
| NV | $262.00 | 1 |
| NY | $252.94–$309.98 | 5 |
| OH | $251.96 | 1 |
| OK | $245.88 | 1 |
| OR | $259.47–$278.10 | 2 |
| PA | $251.79–$274.68 | 2 |
| PR | $265.55 | 1 |
| RI | $269.43 | 1 |
| SC | $251.31 | 1 |
| SD | $254.89 | 1 |
| TN | $244.79 | 1 |
| TX | $250.43–$271.05 | 8 |
| UT | $254.25 | 1 |
| VA | $257.66–$296.90 | 2 |
| VI | $265.55 | 1 |
| VT | $255.85 | 1 |
| WA | $269.78–$299.27 | 2 |
| WI | $248.53 | 1 |
| WV | $251.65 | 1 |
| WY | $260.55 | 1 |
How the 54162 rate is calculated
Each of 54162’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 · 54162
RVUs × geographic indexes × conversion factor
Work3.24
3.24 RVUs× 1.000 GPCI
Practice expense4.25
4.25 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
7.9100
Conversion factor
$33.4009
Medicare rate
$264.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Austin, TX inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,257
- Code
- 54162
- Physician work
- 3.24
- Practice expense
- 4.25
- Malpractice
- 0.42
GPCI2026.csv
96
- Locality
- Austin, TX
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.24 | × 1.002 | 3.2465 |
| Practice expense | 4.25 | × 1.058 | 4.4965 |
| Malpractice | 0.42 | × 0.886 | 0.3721 |
| Total RVUs | 8.1151 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Austin, TX$271.05
Office: (3.24 × 1.002 + 4.25 × 1.058 + 0.42 × 0.886) × $33.4009 = $271.05
Facility: (3.24 × 1.002 + 1.86 × 1.058 + 0.42 × 0.886) × $33.4009 = $186.59
Payment rules and modifiers for 54162
54162 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54162
Penile adhesion lysis, post-circumcision adhesions
| 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 · 54162
Penile adhesion lysis, post-circumcision adhesions
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
54162 without 51 · national office
$264.20
Penile adhesion lysis, post-circumcision adhesions
54162-51 · Second procedure: 50%
$132.10
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%).
How 54162 has changed in Austin, TX
54162 · Office / nonfacility
$271.05
Effective 2026-10-01
The base rate is $16.50 higher than on 2025-10-01, moving from $254.55 to $271.05 (6.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$254.55changed to$271.05
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.32 changed to 3.24
- Practice expense RVU 4.00 changed to 4.25
- Malpractice RVU 0.40 changed to 0.42
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 1.046 changed to 1.058
- Malpractice GPCI 0.914 changed to 0.886
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$262.66changed to$254.55
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.02 changed to 4.00
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$258.37changed to$262.66
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$262.95changed to$258.37
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.94 changed to 4.02
- Practice expense GPCI 1.053 changed to 1.046
- Malpractice GPCI 0.727 changed to 0.914
January 1, 2023
RVU23A
$266.01changed to$262.95
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.92 changed to 3.94
- Practice expense GPCI 1.059 changed to 1.053
- Malpractice GPCI 0.539 changed to 0.727
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$269.51changed to$266.01
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.96 changed to 3.92
- Malpractice RVU 0.39 changed to 0.40
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$266.99changed to$269.51
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.68 changed to 3.96
- Practice expense GPCI 1.040 changed to 1.059
- Malpractice GPCI 0.643 changed to 0.539
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$266.76changed to$266.99
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.72 changed to 3.68
- Malpractice RVU 0.38 changed to 0.39
- Practice expense GPCI 1.021 changed to 1.040
- Malpractice GPCI 0.747 changed to 0.643
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$267.30changed to$266.76
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.75 changed to 3.72
- Malpractice RVU 0.37 changed to 0.38
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$263.18changed to$267.30
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.66 changed to 3.75
- Practice expense GPCI 1.020 changed to 1.021
- Malpractice GPCI 0.757 changed to 0.747
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$261.73changed to$263.18
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.63 changed to 3.66
- Malpractice RVU 0.38 changed to 0.37
- Practice expense GPCI 1.019 changed to 1.020
- Malpractice GPCI 0.766 changed to 0.757
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$261.30changed to$261.73
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.60 changed to 3.63
- Malpractice RVU 0.37 changed to 0.38
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$260.00changed to$261.30
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$258.04changed to$260.00
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.59 changed to 3.60
- Malpractice RVU 0.32 changed to 0.37
- Practice expense GPCI 1.014 changed to 1.019
- Malpractice GPCI 0.759 changed to 0.766
Held through RVU15B.
January 1, 2014
RVU14A
$254.24changed to$258.04
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.87 changed to 3.59
- Malpractice RVU 0.33 changed to 0.32
- Practice expense GPCI 1.009 changed to 1.014
- Malpractice GPCI 0.751 changed to 0.759
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $254.24
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $271.05 | $186.59 | RVU26D |
| 2026-07-01 | $271.05 | $186.59 | RVU26C |
| 2026-04-01 | $271.05 | $186.59 | RVU26B |
| 2026-01-01 | $271.05 | $186.59 | RVU26A |
| 2025-10-01 | $254.55 | $198.39 | RVU25D |
| 2025-07-01 | $254.55 | $198.39 | RVU25C |
| 2025-04-01 | $254.55 | $198.39 | RVU25B |
| 2025-01-01 | $254.55 | $198.39 | RVU25A |
| 2024-10-01 | $262.66 | $202.77 | RVU24D |
| 2024-07-01 | $262.66 | $202.77 | RVU24C |
| 2024-04-01 | $262.66 | $202.77 | RVU24B |
| 2024-03-09 | $262.66 | $202.77 | RVU24AR |
| 2024-01-01 | $258.37 | $199.46 | RVU24A |
| 2023-10-01 | $262.95 | $201.58 | RVU23D |
| 2023-07-01 | $262.95 | $201.58 | RVU23C |
| 2023-04-01 | $262.95 | $201.58 | RVU23B |
| 2023-01-01 | $262.95 | $201.58 | RVU23A |
| 2022-10-01 | $266.01 | $201.15 | RVU22D |
| 2022-07-01 | $266.01 | $201.15 | RVU22C |
| 2022-04-01 | $266.01 | $201.15 | RVU22B |
| 2022-01-01 | $266.01 | $201.15 | RVU22A |
| 2021-10-01 | $269.51 | $201.52 | RVU21D |
| 2021-07-01 | $269.51 | $201.52 | RVU21C |
| 2021-04-01 | $269.51 | $201.52 | RVU21B |
| 2021-01-01 | $269.51 | $201.52 | RVU21A |
| 2020-10-01 | $266.99 | $205.44 | RVU20D |
| 2020-07-01 | $266.99 | $205.44 | RVU20C |
| 2020-04-01 | $266.99 | $205.44 | RVU20B |
| 2020-01-01 | $266.99 | $205.44 | RVU20A |
| 2019-10-01 | $266.76 | $206.05 | RVU19D |
| 2019-07-01 | $266.76 | $206.05 | RVU19C |
| 2019-04-01 | $266.76 | $206.05 | RVU19B |
| 2019-01-01 | $266.76 | $206.05 | RVU19A |
| 2018-10-01 | $267.30 | $206.29 | RVU18D |
| 2018-07-01 | $267.30 | $206.29 | RVU18C |
| 2018-04-01 | $267.30 | $206.29 | RVU18B |
| 2018-01-01 | $267.30 | $206.29 | RVU18AR1 |
| 2017-10-01 | $263.18 | $203.88 | RVU17D |
| 2017-07-01 | $263.18 | $203.88 | RVU17C |
| 2017-04-01 | $263.18 | $203.88 | RVU17B |
| 2017-01-01 | $263.18 | $203.88 | RVU17A |
| 2016-10-01 | $261.73 | $202.99 | RVU16D |
| 2016-07-01 | $261.73 | $202.99 | RVU16C |
| 2016-04-01 | $261.73 | $202.99 | RVU16B |
| 2016-01-01 | $261.73 | $202.99 | RVU16A |
| 2015-10-01 | $261.30 | $203.45 | RVU15D |
| 2015-07-01 | $261.30 | $203.45 | RVU15C |
| 2015-04-01 | $260.00 | $202.44 | RVU15B |
| 2015-01-01 | $260.00 | $202.44 | RVU15A |
| 2014-10-01 | $258.04 | $200.28 | RVU14D |
| 2014-07-01 | $258.04 | $200.28 | RVU14C |
| 2014-04-01 | $258.04 | $200.28 | RVU14B |
| 2014-01-01 | $258.04 | $200.28 | RVU14A |
| 2013-10-01 | $254.24 | $194.85 | RVU13D |
| 2013-07-01 | $254.24 | $194.85 | RVU13C |
| 2013-04-01 | $254.24 | $194.85 | RVU13B |
| 2013-01-01 | $254.24 | $194.85 | RVU13AR |
Where the Austin, TX rate applies
Austin, TX is a Medicare payment area, not a city. Our Census mapping connects it to 31 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- 54162 in Austin · multiple payment areas
- 54162 in Barton Creek
- 54162 in Bee Cave
- 54162 in Briarcliff
- 54162 in Cedar Park · multiple payment areas
- 54162 in Creedmoor · multiple payment areas
- 54162 in Elgin · multiple payment areas
- 54162 in Garfield
54162 billing questions
When should 54162 be chosen instead of a circumcision code?
Use 54162 when the service releases or removes adhesions between penile skin and the glans after circumcision. Choose a circumcision code when circumcision itself is performed.
Is 54162 the code for correcting an incomplete circumcision?
No. 54162 addresses adhesions. Code 54163 is the nearby code for repair of a circumcision; select based on the procedure actually performed.
Can modifier 50 be used for adhesions on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. 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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