CPT code 54163: Circumcision repair, revision after prior circumcision2026 Medicare rate & RVUs in South Dakota
Surgical revision of a prior circumcision to correct residual foreskin or an unsatisfactory result when operative repair, rather than initial circumcision, is performed.
In South Dakota, Medicare pays $197.77 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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $197.77. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$197.77
- Los Angeles, CA · California$222.33+$24.56
- Washington, DC area · District of Columbia$229.62+$31.85
- Miami, FL · Florida$232.01+$34.24
- Chicago, IL · Illinois$226.43+$28.66
- Manhattan, NY · New York$235.98+$38.21
- Alaska · Alaska$260.41+$62.64
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $190.39 |
| ArkansasArkansas | — | $188.32 |
| ArizonaArizona | — | $202.44 |
| Bakersfield, CACalifornia | — | $211.80 |
| Chico, CACalifornia | — | $210.56 |
| El Centro, CACalifornia | — | $210.63 |
| Fresno, CACalifornia | — | $210.56 |
| Hanford, CACalifornia | — | $210.56 |
| Madera, CACalifornia | — | $210.56 |
| Merced, CACalifornia | — | $210.56 |
| Modesto, CACalifornia | — | $210.56 |
| Napa, CACalifornia | — | $233.98 |
| Oxnard, CACalifornia | — | $220.27 |
| Redding, CACalifornia | — | $210.56 |
| Rest of CaliforniaCalifornia | — | $210.56 |
| Riverside, CACalifornia | — | $215.12 |
| Sacramento, CACalifornia | — | $218.30 |
| Salinas, CACalifornia | — | $217.42 |
| San Diego, CACalifornia | — | $220.54 |
| Marin County, CACalifornia | — | $244.56 |
| San Francisco, CACalifornia | — | $244.08 |
| San Benito County, CACalifornia | — | $249.98 |
| Santa Clara County, CACalifornia | — | $248.03 |
| San Luis Obispo, CACalifornia | — | $214.21 |
| Santa Cruz, CACalifornia | — | $221.09 |
| Santa Maria, CACalifornia | — | $217.69 |
| Santa Rosa, CACalifornia | — | $223.17 |
| Stockton, CACalifornia | — | $210.56 |
| Vallejo, CACalifornia | — | $233.29 |
| Visalia, CACalifornia | — | $210.56 |
| Yuba City, CACalifornia | — | $210.56 |
| ColoradoColorado | — | $210.74 |
| ConnecticutConnecticut | — | $218.73 |
| DelawareDelaware | — | $205.19 |
| Fort Lauderdale, FLFlorida | — | $219.52 |
| Rest of FloridaFlorida | — | $210.41 |
| Atlanta, GAGeorgia | — | $211.59 |
| Rest of GeorgiaGeorgia | — | $200.62 |
| Hawaii, Guam, HIHawaii | — | $212.80 |
| IowaIowa | — | $191.42 |
| IdahoIdaho | — | $192.91 |
| East St. Louis, ILIllinois | — | $214.52 |
| Rest of IllinoisIllinois | — | $207.60 |
| Suburban Chicago, ILIllinois | — | $220.96 |
| IndianaIndiana | — | $193.68 |
| KansasKansas | — | $191.98 |
| KentuckyKentucky | — | $196.48 |
| New Orleans, LALouisiana | — | $203.99 |
| Rest of LouisianaLouisiana | — | $196.74 |
| Metropolitan Boston, MAMassachusetts | — | $226.44 |
| Rest of MassachusettsMassachusetts | — | $210.47 |
| Baltimore area, MDMaryland | — | $218.34 |
| Rest of MarylandMaryland | — | $208.04 |
| Rest of MaineMaine | — | $195.00 |
| Southern Maine, MEMaine | — | $201.15 |
| Detroit, MIMichigan | — | $213.74 |
| Rest of MichiganMichigan | — | $201.51 |
| MinnesotaMinnesota | — | $199.67 |
| Metropolitan Kansas City, MOMissouri | — | $201.59 |
| Metropolitan St. Louis, MOMissouri | — | $203.04 |
| Rest of MissouriMissouri | — | $195.01 |
| MississippiMississippi | — | $191.63 |
| MontanaMontana | — | $207.06 |
| North CarolinaNorth Carolina | — | $196.34 |
| North DakotaNorth Dakota | — | $198.75 |
| NebraskaNebraska | — | $191.83 |
| New HampshireNew Hampshire | — | $208.81 |
| Northern New JerseyNew Jersey | — | $228.43 |
| Rest of New JerseyNew Jersey | — | $220.58 |
| New MexicoNew Mexico | — | $202.86 |
| NevadaNevada | — | $204.83 |
| NYC suburbs and Long Island, NYNew York | — | $242.07 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $222.96 |
| Queens, NYNew York | — | $235.65 |
| Rest of New YorkNew York | — | $198.68 |
| OhioOhio | — | $199.82 |
| OklahomaOklahoma | — | $194.88 |
| Portland, OROregon | — | $214.64 |
| Rest of OregonOregon | — | $202.58 |
| Metropolitan Philadelphia, PAPennsylvania | — | $215.22 |
| Rest of PennsylvaniaPennsylvania | — | $199.36 |
| Puerto RicoPuerto Rico | — | $207.81 |
| Rhode IslandRhode Island | — | $210.43 |
| South CarolinaSouth Carolina | — | $198.53 |
| TennesseeTennessee | — | $192.87 |
| Austin, TXTexas | — | $210.62 |
| Beaumont, TXTexas | — | $198.45 |
| Brazoria, TXTexas | — | $204.10 |
| Dallas, TXTexas | — | $205.73 |
| Fort Worth, TXTexas | — | $205.06 |
| Galveston, TXTexas | — | $204.94 |
| Houston, TXTexas | — | $212.63 |
| Rest of TexasTexas | — | $201.40 |
| UtahUtah | — | $200.56 |
| VirginiaVirginia | — | $201.52 |
| Virgin Islands, VIUnited States Virgin Islands | — | $207.81 |
| VermontVermont | — | $199.31 |
| Rest of WashingtonWashington | — | $209.64 |
| King County, WAWashington | — | $229.19 |
| WisconsinWisconsin | — | $193.81 |
| West VirginiaWest Virginia | — | $202.02 |
| WyomingWyoming | — | $203.44 |
54163 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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,258
- Code
- 54163
- Physician work
- 3.24
- Practice expense
- 2.54
- Malpractice
- 0.42
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.24 | × 1.000 | 3.2400 |
| Practice expense | 2.54 | × 1.000 | 2.5400 |
| Malpractice | 0.42 | × 0.336 | 0.1411 |
| Total RVUs | 5.9211 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, South Dakota$197.77
Facility: (3.24 × 1 + 2.54 × 1 + 0.42 × 0.336) × $33.4009 = $197.77
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%).
How 54163 has changed in South Dakota
54163 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $197.77 | RVU26D |
| 2026-07-01 | Not available in this setting | $197.77 | RVU26C |
| 2026-04-01 | Not available in this setting | $197.77 | RVU26B |
| 2026-01-01 | Not available in this setting | $197.77 | RVU26A |
| 2025-10-01 | Not available in this setting | $207.43 | RVU25D |
| 2025-07-01 | Not available in this setting | $207.43 | RVU25C |
| 2025-04-01 | Not available in this setting | $207.43 | RVU25B |
| 2025-01-01 | Not available in this setting | $207.43 | RVU25A |
| 2024-10-01 | Not available in this setting | $211.80 | RVU24D |
| 2024-07-01 | Not available in this setting | $211.80 | RVU24C |
| 2024-04-01 | Not available in this setting | $211.80 | RVU24B |
| 2024-03-09 | Not available in this setting | $211.80 | RVU24AR |
| 2024-01-01 | Not available in this setting | $208.34 | RVU24A |
| 2023-10-01 | Not available in this setting | $211.31 | RVU23D |
| 2023-07-01 | Not available in this setting | $211.31 | RVU23C |
| 2023-04-01 | Not available in this setting | $211.31 | RVU23B |
| 2023-01-01 | Not available in this setting | $211.31 | RVU23A |
| 2022-10-01 | Not available in this setting | $212.09 | RVU22D |
| 2022-07-01 | Not available in this setting | $212.09 | RVU22C |
| 2022-04-01 | Not available in this setting | $212.09 | RVU22B |
| 2022-01-01 | Not available in this setting | $212.09 | RVU22A |
| 2021-10-01 | Not available in this setting | $213.03 | RVU21D |
| 2021-07-01 | Not available in this setting | $213.03 | RVU21C |
| 2021-04-01 | Not available in this setting | $213.03 | RVU21B |
| 2021-01-01 | Not available in this setting | $213.03 | RVU21A |
| 2020-10-01 | Not available in this setting | $217.39 | RVU20D |
| 2020-07-01 | Not available in this setting | $217.39 | RVU20C |
| 2020-04-01 | Not available in this setting | $217.39 | RVU20B |
| 2020-01-01 | Not available in this setting | $217.39 | RVU20A |
| 2019-10-01 | Not available in this setting | $219.04 | RVU19D |
| 2019-07-01 | Not available in this setting | $219.04 | RVU19C |
| 2019-04-01 | Not available in this setting | $219.04 | RVU19B |
| 2019-01-01 | Not available in this setting | $219.04 | RVU19A |
| 2018-10-01 | Not available in this setting | $220.10 | RVU18D |
| 2018-07-01 | Not available in this setting | $220.10 | RVU18C |
| 2018-04-01 | Not available in this setting | $220.10 | RVU18B |
| 2018-01-01 | Not available in this setting | $220.10 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $218.21 | RVU17D |
| 2017-07-01 | Not available in this setting | $218.21 | RVU17C |
| 2017-04-01 | Not available in this setting | $218.21 | RVU17B |
| 2017-01-01 | Not available in this setting | $218.21 | RVU17A |
| 2016-10-01 | Not available in this setting | $216.69 | RVU16D |
| 2016-07-01 | Not available in this setting | $216.69 | RVU16C |
| 2016-04-01 | Not available in this setting | $216.69 | RVU16B |
| 2016-01-01 | Not available in this setting | $216.69 | RVU16A |
| 2015-10-01 | Not available in this setting | $216.97 | RVU15D |
| 2015-07-01 | Not available in this setting | $216.97 | RVU15C |
| 2015-04-01 | Not available in this setting | $215.89 | RVU15B |
| 2015-01-01 | Not available in this setting | $215.89 | RVU15A |
| 2014-10-01 | Not available in this setting | $214.69 | RVU14D |
| 2014-07-01 | Not available in this setting | $214.69 | RVU14C |
| 2014-04-01 | Not available in this setting | $214.69 | RVU14B |
| 2014-01-01 | Not available in this setting | $214.69 | RVU14A |
| 2013-10-01 | Not available in this setting | $210.01 | RVU13D |
| 2013-07-01 | Not available in this setting | $210.01 | RVU13C |
| 2013-04-01 | Not available in this setting | $210.01 | RVU13B |
| 2013-01-01 | Not available in this setting | $210.01 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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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