CPT code 54312: Urethral reconstruction, hypospadias repair2026 Medicare rate & RVUs in Missouri
Reports operative reconstruction of the urethra for hypospadias when the documented repair meets this code’s specific anatomic and procedural criteria.
CMS doesn’t publish an office rate for 54312 in Missouri.
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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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $726.78 |
| Metropolitan St. Louis, MO | Unavailable | $731.00 |
| Rest of Missouri | Unavailable | $710.63 |
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.
How the rate is built · 54312
RVUs × geographic indexes × conversion factor
Work14.15
14.15 RVUs× 1.000 GPCI
Practice expense6.21
6.21 RVUs× 1.000 GPCI
Malpractice1.82
1.82 RVUs× 1.000 GPCI
Adjusted RVUs
22.1800
Conversion factor
$33.4009
Medicare rate
$740.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54312
54312 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54312
Urethral reconstruction, hypospadias repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 54312
Urethral reconstruction, hypospadias repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54312 without 51 · national facility
$740.83
Urethral reconstruction, hypospadias repair
54312-51 · Second procedure: 50%
$370.42
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%).
54312 compared with similar codes
Compare codes · National
4 codes, side by side
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.
54312 billing questions
How should I distinguish this code from other hypospadias repairs?
Use the full CPT descriptor and operative documentation to match the repair’s anatomy and technique. The general CMS short descriptor alone does not distinguish the reconstruction codes in this family.
Is related postoperative care separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
Can I append modifier 50 for bilateral repair?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens if another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others.
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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