CPT code 54163: Circumcision repair, revision after prior circumcision2026 Medicare rate & RVUs in North Carolina

In North Carolina, Medicare pays $196.34 for 54163 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 54163 nationwide

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

What 54163 covers

This service revises anatomy after an earlier circumcision, such as correcting residual foreskin or an irregular result that requires surgical repair. A urologist or pediatric urologist typically performs the procedure in an operating room or ambulatory surgery setting. It is distinct from performing a circumcision for the first time and from treating an isolated adhesion or frenular problem.

Report 54163 when the operative service repairs a prior circumcision, not merely because circumcision appears in the history. The record should identify the prior procedure, the specific defect or residual tissue, and the repair performed. The 10-day global period includes related postoperative visits during that period. 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. Medicare does not pay an assistant at surgery for this service; 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 North Carolina compares for 54163

Across 109 of 109 payment localities, the facility rate for 54163 runs from $188.32 in Arkansas to $260.41 in Alaska. North Carolina pays $196.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

54163 rates by state

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

See 54163 in every payment locality

How the 54163 rate is calculated

Each of 54163’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.

Payment rules and modifiers for 54163

54163 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 54163

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

How 54163 has changed in North Carolina

Price 54163 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Advance
• Ahoskie
• Alamance
• Albemarle
• Alexis
• Alliance
• Altamahaw

Browse all communities in North Carolina

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

Open CMS sourceHow we calculate rates