CPT code 54328: Penile reconstruction, penis and urethra2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $919.89 for 54328 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 54328 nationwide

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

What 54328 covers

This code represents complex reconstructive surgery involving penile and urethral anatomy, rather than a repair limited to one structure. A urologist typically performs the operation in a hospital or other surgical setting. The operative report should make clear the condition being corrected, the structures addressed, and the reconstructive steps performed. Hypospadias-related reconstruction may be part of this clinical context, but the code should be selected based on the actual procedure and its documented scope.

The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 for this code. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. The operative note should distinguish this combined penile and urethral reconstruction from a procedure addressing only the urethra, a specific hypospadias repair, or a limited penile revision.

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 Washington, DC area compares for 54328

Across 109 of 109 payment localities, the facility rate for 54328 runs from $777.09 in Arkansas to $1,100.38 in Alaska. Washington, DC area pays $919.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

54328 rates by state

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

See 54328 in every payment locality

How the 54328 rate is calculated

Each of 54328’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 54328

54328 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

Codes related to 54328

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

How 54328 has changed in Washington, DC area

Price 54328 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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