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Billing code 54161: CircumcisionMedicare rate & RVUs

Reports surgical removal of the foreskin in a patient aged 28 days or older, using an excisional technique rather than a clamp or device.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.2K Medicare services in 2024

Medicare pays $181.03 for 54161 nationally in a facility.

Medicare rate · 54161

Circumcision

Swap in your local Medicare rate.

Work RVUs
3.24
Total RVUs
5.42
Global days
010

National rate · 2026

$181.03

Facility setting, before claim adjustments.

See every locality for 54161 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 54161 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 54161 covers

This code is for circumcision performed by surgically excising the foreskin in a patient who is at least 28 days old. Urologists, pediatric surgeons, and other surgeons may perform it in an office procedure room or an operating room. Common clinical reasons include phimosis or recurrent inflammation of the foreskin; the record should identify the indication and the excisional approach.

Choose this code by the patient’s age and the method used, not simply by the fact that circumcision was performed. Document the age, indication, and operative work. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate for this procedure. Assistant-at-surgery services are not paid; 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 54161 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

54161 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$167.60
Alaska*Unavailable$232.66
ArizonaUnavailable$177.19
ArkansasUnavailable$165.94
AtlantaUnavailable$185.12
AustinUnavailable$183.06
BakersfieldUnavailable$183.25
Baltimore/Surr. CntysUnavailable$190.38
BeaumontUnavailable$174.75
BrazoriaUnavailable$178.28

54161 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
54161 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 54161 rate is calculated

Each of 54161’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 · 54161

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.24Practice expense 1.76Malpractice 0.42

5.4200 adjusted RVUs×$33.4009 conversion factor=$181.03

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 54161

54161 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54161

Circumcision

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 54161

Circumcision

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

54161 without 51 · national facility

$181.03

Circumcision

54161-51 · Second procedure: 50%

$90.52

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%).

When to use modifier 51

54161 compared with similar codes

Compare codes

54161 vs 54160 vs 54150 vs 54163: national Medicare rates

Swap in your local Medicare rate.

  • 54161
    Circumcision · 3.24 wRVU
    —
  • 54160
    Circumcision · 2.47 wRVU
    $228.46
  • 54150
    Circumcision · 1.85 wRVU
    $151.97
  • 54163
    Circumcision repair · 3.24 wRVU
    —

How to choose

54160Circumcision
Both describe excisional circumcision; select 54160 for a newborn younger than 28 days and 54161 at 28 days or older.
54150Circumcision
This code is for a clamp- or device-based method with a regional penile block, rather than the excisional method reported with 54161.
54163Circumcision repair
Code 54163 concerns repair of a prior circumcision, not the initial excisional removal of foreskin reported with 54161.

Codes related to 54161

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

Codes related to 54161
CodeHow it relatesNational office range
Same family
54160CircumcisionExcisional circumcision for a newborn younger than 28 days.$204.09–$292.07
Used instead
54150CircumcisionCircumcision performed with a clamp or other device and a regional penile block.$136.50–$191.37

54161 billing questions

How does this differ from circumcision code 54160?

Code 54161 is for excisional circumcision at age 28 days or older. Code 54160 is the excisional circumcision code for a newborn younger than 28 days.

When should 54150 be considered instead?

Code 54150 describes circumcision using a clamp or other device with a regional penile block. Use 54161 when the documented method is surgical excision in a patient at least 28 days old.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure payment.

How are multiple procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in that session are paid at 50% under the standard multiple procedure reduction.

Can modifier 50 or an assistant-at-surgery service be reported?

Modifier 50 is inappropriate for this procedure. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are 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
RVUs for 54161PPRRVU2026_Oct_nonQPP.csv, line 6,256 (RVU26D)

Open CMS sourceHow we calculate rates

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