CPT code 54163: Circumcision repair, revision after prior circumcision2026 Medicare rate & RVUs in New Jersey
Surgical revision of a prior circumcision to correct residual foreskin or an unsatisfactory result when operative repair, rather than initial circumcision, is performed.
CMS doesn’t publish an office rate for 54163 in New Jersey.
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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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.
Where 54163 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | Unavailable | $228.43 |
| Rest of New Jersey | Unavailable | $220.58 |
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.
How the rate is built · 54163
RVUs × geographic indexes × conversion factor
Work3.24
3.24 RVUs× 1.000 GPCI
Practice expense2.54
2.54 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
6.2000
Conversion factor
$33.4009
Medicare rate
$207.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54163
54163 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54163
Circumcision repair, revision after prior circumcision
| 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 · 54163
Circumcision repair, revision after prior circumcision
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
54163 without 51 · national facility
$207.09
Circumcision repair, revision after prior circumcision
54163-51 · Second procedure: 50%
$103.55
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%).
54163 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 54160CircumcisionNeonate, surgical excision
- 54160 is an initial circumcision procedure for a neonate. Use 54163 when the service surgically corrects a prior circumcision.
- 54161CircumcisionAge 28 days or older
- 54161 is an initial circumcision procedure for a patient 28 days or older. It does not describe revision of a prior circumcision.
- 54162Penile adhesion lysisPost-circumcision adhesions
- 54162 describes lysis of penile adhesions. Choose 54163 when the operative target is repair of the circumcision result rather than isolated adhesion release.
- 54164FrenulotomyPenile frenulum
- 54164 describes a penile frenulotomy. Choose 54163 for repair of a circumcision defect, not an isolated frenular procedure.
54163 billing questions
How is repair different from a new circumcision?
Use 54163 for operative correction after a prior circumcision. Codes 54160 and 54161 describe circumcision procedures, not repair of an earlier result.
Is isolated penile adhesion release reported as a circumcision repair?
No. Code 54162 describes lysis of penile adhesions; 54163 is for repair of the circumcision itself.
What documentation supports 54163?
Document the prior circumcision, the specific residual tissue or other defect, and the operative steps used to correct it.
Are related postoperative visits included?
Yes. Related postoperative visits during the 10-day global period are included in the procedure.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for 54163.
Can co-surgeons or a surgical team report the repair?
No. CMS lists co-surgeons and team surgery as not permitted for this code.
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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