CPT code 54318: Urethral reconstruction, second stage2026 Medicare rate & RVUs in Georgia
Reports the later operation in a planned two-stage reconstruction of the male anterior urethra, typically closing the urethral opening created during the first stage.
CMS doesn’t publish an office rate for 54318 in Georgia.
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 54318 covers
This code represents the planned second operation in a staged reconstruction of the male anterior urethra. The surgeon completes the urethral channel using tissue shaped or prepared during the initial operation, often closing a temporary urethral opening. Urologists typically perform the procedure in an operating room when a urethral defect or stricture is managed in stages rather than reconstructed in one operation.
Report it for the second stage, not for the initial preparation or a one-stage repair. The operative report should identify the prior staged reconstruction and describe the work completing the urethra. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be available; 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 54318 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta, GA | Unavailable | $662.04 |
| Rest of Georgia | Unavailable | $636.75 |
How the 54318 rate is calculated
Each of 54318’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 · 54318
RVUs × geographic indexes × conversion factor
Work12.12
12.12 RVUs× 1.000 GPCI
Practice expense5.70
5.70 RVUs× 1.000 GPCI
Malpractice1.56
1.56 RVUs× 1.000 GPCI
Adjusted RVUs
19.3800
Conversion factor
$33.4009
Medicare rate
$647.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54318
54318 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54318
Urethral reconstruction, second stage
| 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 · 54318
Urethral reconstruction, second stage
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
54318 without 51 · national facility
$647.31
Urethral reconstruction, second stage
54318-51 · Second procedure: 50%
$323.66
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%).
54318 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 54316Urethral reconstructionSecond stage
- This code is for the later operation completing a staged reconstruction; 54316 is used for the initial stage.
- 54308Urethral reconstructionOne-stage, anterior urethra
- Use 54308 for a one-stage urethral reconstruction. This code is for the planned second operation in a two-stage repair.
- 54324Hypospadias repairMidshaft to proximal penile
- 54324 is a hypospadias repair code. Select the code that matches the documented condition and operative repair rather than treating it as a general second-stage urethral reconstruction code.
54318 billing questions
How is this distinguished from the first-stage operation?
Use this code for the planned later operation that completes the urethral reconstruction. The first-stage procedure prepares the tissue or creates the opening used for that later repair.
Can it be reported for a one-stage urethral reconstruction?
No. This code represents the second stage of a planned two-stage reconstruction; a one-stage reconstruction belongs to the applicable one-stage code.
What documentation supports reporting the second stage?
Document the prior staged reconstruction, the current operative work completing the urethra, and the relationship between the two stages.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral work?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made, co-surgeons require supporting documentation, and team surgery is not permitted.
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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