CPT code 54164: Frenulotomy, penile frenulum2026 Medicare rate & RVUs in Florida
Reports surgical release of a short or tethered penile frenulum, typically performed to relieve restricted movement or discomfort.
CMS doesn’t publish an office rate for 54164 in Florida.
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 54164 covers
A penile frenulotomy releases a tight band of tissue connecting the underside of the glans to the foreskin. Urologists commonly perform it for a short or tethered frenulum that restricts foreskin movement or causes discomfort, including during erection. The service may be performed in an operating room or another appropriate procedural setting; document the frenular finding and the release performed.
Report 54164 for the frenular release itself, not for circumcision or lysis of penile adhesions. The operative note should identify the frenulum as the treated structure and describe the incision or release. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 54164 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $196.15 |
| Miami, FL | Unavailable | $207.10 |
| Rest of Florida | Unavailable | $187.84 |
How the 54164 rate is calculated
Each of 54164’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 · 54164
RVUs × geographic indexes × conversion factor
Work2.75
2.75 RVUs× 1.000 GPCI
Practice expense2.44
2.44 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
5.5500
Conversion factor
$33.4009
Medicare rate
$185.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54164
54164 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54164
Frenulotomy, penile frenulum
| 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 · 54164
Frenulotomy, penile frenulum
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
54164 without 51 · national facility
$185.37
Frenulotomy, penile frenulum
54164-51 · Second procedure: 50%
$92.69
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%).
54164 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 54162Penile adhesion lysisPost-circumcision adhesions
- Use 54164 for release of the penile frenulum. Use 54162 for lysis of penile adhesions.
- 54160CircumcisionNeonate, surgical excision
- 54160 reports circumcision in a neonate; 54164 reports release of the penile frenulum, not removal of the foreskin.
- 54161CircumcisionAge 28 days or older
- 54161 reports circumcision at age 28 days or older. Choose 54164 when the service is frenular release rather than circumcision.
54164 billing questions
How is 54164 different from lysis of penile adhesions?
54164 releases the penile frenulum, the tissue band beneath the glans. Code 54162 describes lysis of penile adhesions, a different anatomic problem.
Can 54164 be reported with a circumcision code?
A separate frenular release may be performed during the same session as circumcision. Document the distinct frenular problem and work; do not treat the circumcision itself as the frenulotomy.
What documentation supports 54164?
Document the short or tethered frenulum, the clinical reason for release, and the specific release performed. The record should distinguish this work from circumcision or treatment of adhesions.
Does 54164 have a postoperative global period?
Yes. The 10-day global period includes related postoperative visits during those 10 days.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for 54164.
How does Medicare handle 54164 with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction. Co-surgeons and team surgery are not permitted for 54164.
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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