CPT code 54312: Urethral reconstruction, hypospadias repair2026 Medicare rate & RVUs

Medicare pays $740.83 for 54312 nationally in a facility.

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

What 54312 covers

This code is used for operative urethral reconstruction in a patient with hypospadias, a congenital condition in which the urethral opening is not at the usual position. The surgeon reconstructs the urethral passage and creates or relocates its opening as part of the repair. Pediatric urologists and other surgeons with appropriate reconstructive expertise typically perform these procedures in an operating room, often in a hospital or ambulatory surgery center.

Select this code from the operative report’s documented anatomy, extent of reconstruction, and technique, using the full CPT descriptor to distinguish it from other hypospadias repair codes. Documentation should identify the urethral defect, operative steps, and any associated reconstruction. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 54312 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

54312 rates by state

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

How the 54312 rate is calculated

Each of 54312’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 54312

54312 has a 90-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

54312 compared with similar codes

How to choose

54308Urethral reconstructionOne-stage, anterior urethra

Both are in the hypospadias reconstruction family. Choose between them by matching the documented operative circumstances to each code’s full CPT criteria.

54316Urethral reconstructionSecond stage

This is a staged-reconstruction option in the same family. The operative plan and stage documented determine whether it applies instead.

54318Urethral reconstructionSecond stage

This is another staged-reconstruction option. Distinguish it by the stage and procedure documented, rather than by the general urethral reconstruction label.

Codes related to 54312

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

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