Billing code 54162: Penile adhesion lysisMedicare rate & RVUs
Reports release or excision of adhesions between penile skin and the glans after circumcision, commonly performed in an office or outpatient setting.
Medicare pays $264.20 for 54162 nationally in the office and $184.37 in a hospital or facility. Local office rates run $237.38–$332.34.
Medicare rate · 54162
Penile adhesion lysis
Swap in your local Medicare rate.
- Work RVUs
- 3.24
- Total RVUs
- 7.91
- Global days
- 010
National rate · 2026
$264.20
Office setting, before claim adjustments.
See every locality for 54162 → · 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
What 54162 covers
This service releases or removes penile adhesions that have formed after circumcision, separating skin attached to the glans. Urologists and other clinicians who perform penile procedures may treat these adhesions in an office or outpatient setting. The operative target is the adhesion itself, rather than a new circumcision, repair of an incomplete circumcision, or release of the frenulum.
Report the code when the documented procedure is lysis or excision of post-circumcision penile adhesions. The record should identify the adhesions and describe the release or removal performed. The service has a 10-day global period, so related postoperative visits during that period 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; assistant-at-surgery payment is restricted, and 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 54162 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$237.38 to $332.34
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $240.37 | $170.52 |
| Alaska* | $321.24 | $236.22 |
| Arizona | $257.78 | $180.43 |
| Arkansas | $237.38 | $168.81 |
| Atlanta | $269.62 | $188.51 |
| Austin | $271.05 | $186.59 |
| Bakersfield | $274.40 | $186.91 |
| Baltimore/Surr. Cntys | $279.62 | $193.96 |
| Beaumont | $250.43 | $177.79 |
| Brazoria | $260.70 | $181.59 |
| Chicago | $283.84 | $203.61 |
| Chico | $273.16 | $185.67 |
| Colorado | $271.51 | $186.58 |
| Connecticut | $280.24 | $194.27 |
| Dallas | $262.62 | $183.11 |
| Dc + Md/Va Suburbs | $296.90 | $202.86 |
| Delaware | $261.62 | $182.75 |
| Detroit | $268.86 | $191.82 |
| East St. Louis | $267.07 | $193.63 |
| El Centro | $273.23 | $185.74 |
| Fort Lauderdale | $277.38 | $196.52 |
| Fort Worth | $261.38 | $182.67 |
| Fresno | $273.16 | $185.67 |
| Galveston | $261.66 | $182.39 |
| Hanford-Corcoran | $273.16 | $185.67 |
| Hawaii, Guam | $277.74 | $186.98 |
| Houston | $269.35 | $190.08 |
| Idaho | $245.45 | $172.01 |
| Indiana | $246.63 | $172.63 |
| Iowa | $243.68 | $170.63 |
| Kansas | $243.62 | $171.45 |
| Kentucky | $247.25 | $176.28 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $289.90 | $195.47 |
| Madera | $273.16 | $185.67 |
| Manhattan | $302.34 | $209.58 |
| Merced | $273.16 | $185.67 |
| Metropolitan Boston | $294.63 | $199.32 |
| Metropolitan Kansas City | $255.22 | $180.26 |
| Metropolitan Philadelphia | $274.68 | $191.58 |
| Metropolitan St. Louis | $257.42 | $181.42 |
| Miami | $291.47 | $208.37 |
| Minnesota | $258.44 | $176.30 |
| Mississippi | $240.81 | $172.08 |
| Modesto | $273.16 | $185.67 |
| Montana** | $264.17 | $184.34 |
| Napa | $309.26 | $204.04 |
| Nebraska | $244.55 | $170.86 |
| Nevada** | $262.00 | $182.09 |
| New Hampshire | $268.27 | $185.17 |
| New Mexico | $255.24 | $182.04 |
| New Orleans | $257.73 | $182.62 |
| North Carolina | $249.63 | $175.15 |
| North Dakota** | $255.87 | $176.04 |
| Northern Nj | $294.69 | $202.08 |
| Nyc Suburbs/Long Island | $309.98 | $215.06 |
| Ohio | $251.96 | $179.08 |
| Oklahoma | $245.88 | $174.60 |
| Oxnard-Thousand Oaks-Ventura | $287.78 | $193.42 |
| Portland | $278.10 | $189.41 |
| Poughkpsie/N Nyc Suburbs | $285.50 | $198.09 |
| Puerto Rico | $265.55 | $184.85 |
| Queens | $303.16 | $208.81 |
| Redding | $273.16 | $185.67 |
| Rest Of California | $273.16 | $185.67 |
| Rest Of Florida | $265.01 | $188.70 |
| Rest Of Georgia | $251.56 | $180.36 |
| Rest Of Illinois | $259.75 | $186.87 |
| Rest Of Louisiana | $247.29 | $176.64 |
| Rest Of Maine | $247.54 | $174.10 |
| Rest Of Maryland | $265.84 | $185.05 |
| Rest Of Massachusetts | $270.61 | $186.55 |
| Rest Of Michigan | $253.66 | $180.78 |
| Rest Of Missouri | $244.25 | $175.43 |
| Rest Of New Jersey | $282.95 | $195.78 |
| Rest Of New York | $252.94 | $177.10 |
| Rest Of Oregon | $259.47 | $179.96 |
| Rest Of Pennsylvania | $251.79 | $178.51 |
| Rest Of Texas | $255.60 | $179.84 |
| Rest Of Washington | $269.78 | $185.72 |
| Rhode Island | $269.43 | $186.96 |
| Riverside-San Bernardino-Ontario | $277.71 | $190.22 |
| Sacramento-Roseville-Folsom | $284.73 | $191.89 |
| Salinas | $283.62 | $191.10 |
| San Diego-Chula Vista-Carlsbad | $288.85 | $193.37 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $325.09 | $212.54 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $324.62 | $212.06 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $332.34 | $217.23 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $330.39 | $215.28 |
| San Luis Obispo-Paso Robles | $279.26 | $188.34 |
| Santa Cruz-Watsonville | $290.48 | $193.49 |
| Santa Maria-Santa Barbara | $284.29 | $191.21 |
| Santa Rosa-Petaluma | $293.30 | $195.28 |
| Seattle (King Cnty) | $299.27 | $201.32 |
| South Carolina | $251.31 | $177.55 |
| South Dakota** | $254.89 | $175.06 |
| Southern Maine | $257.75 | $178.64 |
| Stockton | $273.16 | $185.67 |
| Suburban Chicago | $279.62 | $197.64 |
| Tennessee | $244.79 | $172.22 |
| Utah | $254.25 | $179.21 |
| Vallejo | $308.57 | $203.36 |
| Vermont | $255.85 | $176.82 |
| Virgin Islands | $265.55 | $184.85 |
| Virginia | $257.66 | $179.19 |
| Visalia | $273.16 | $185.67 |
| West Virginia | $251.65 | $182.28 |
| Wisconsin | $248.53 | $172.06 |
| Wyoming** | $260.55 | $180.73 |
| Yuba City | $273.16 | $185.67 |
54162 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$237.38
$321.24
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $321.24 | 1 |
| AL | $240.37 | 1 |
| AR | $237.38 | 1 |
| AZ | $257.78 | 1 |
| CA | $273.16–$332.34 | 29 |
| CO | $271.51 | 1 |
| CT | $280.24 | 1 |
| DC | $296.90 | 1 |
| DE | $261.62 | 1 |
| FL | $265.01–$291.47 | 3 |
| GA | $251.56–$269.62 | 2 |
| GU | $277.74 | 1 |
| HI | $277.74 | 1 |
| IA | $243.68 | 1 |
| ID | $245.45 | 1 |
| IL | $259.75–$283.84 | 4 |
| IN | $246.63 | 1 |
| KS | $243.62 | 1 |
| KY | $247.25 | 1 |
| LA | $247.29–$257.73 | 2 |
| MA | $270.61–$294.63 | 2 |
| MD | $265.84–$296.90 | 3 |
| ME | $247.54–$257.75 | 2 |
| MI | $253.66–$268.86 | 2 |
| MN | $258.44 | 1 |
| MO | $244.25–$257.42 | 3 |
| MS | $240.81 | 1 |
| MT | $264.17 | 1 |
| NC | $249.63 | 1 |
| ND | $255.87 | 1 |
| NE | $244.55 | 1 |
| NH | $268.27 | 1 |
| NJ | $282.95–$294.69 | 2 |
| NM | $255.24 | 1 |
| NV | $262.00 | 1 |
| NY | $252.94–$309.98 | 5 |
| OH | $251.96 | 1 |
| OK | $245.88 | 1 |
| OR | $259.47–$278.10 | 2 |
| PA | $251.79–$274.68 | 2 |
| PR | $265.55 | 1 |
| RI | $269.43 | 1 |
| SC | $251.31 | 1 |
| SD | $254.89 | 1 |
| TN | $244.79 | 1 |
| TX | $250.43–$271.05 | 8 |
| UT | $254.25 | 1 |
| VA | $257.66–$296.90 | 2 |
| VI | $265.55 | 1 |
| VT | $255.85 | 1 |
| WA | $269.78–$299.27 | 2 |
| WI | $248.53 | 1 |
| WV | $251.65 | 1 |
| WY | $260.55 | 1 |
How the 54162 rate is calculated
Each of 54162’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 · 54162
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.24Practice expense 4.25Malpractice 0.42
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54162
54162 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54162
Penile adhesion lysis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 54162
Penile adhesion lysis
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54162 without 51 · national office
$264.20
Penile adhesion lysis
54162-51 · Second procedure: 50%
$132.10
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%).
54162 compared with similar codes
Compare codes
54162 vs 54160 vs 54161 vs 54163 vs 54164: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54160Circumcision
- 54160 describes neonatal circumcision. Use 54162 for release or removal of post-circumcision adhesions, not for circumcision itself.
- 54161Circumcision
- 54161 is the circumcision code for patients 28 days or older. 54162 addresses adhesions after circumcision.
- 54163Circumcision repair
- 54163 is for repair of a circumcision; 54162 is for lysis or excision of penile adhesions.
- 54164Frenulotomy
- 54164 treats a penile frenulum. Use 54162 when the structure being released is an adhesion between penile skin and the glans.
54162 billing questions
When should 54162 be chosen instead of a circumcision code?
Use 54162 when the service releases or removes adhesions between penile skin and the glans after circumcision. Choose a circumcision code when circumcision itself is performed.
Is 54162 the code for correcting an incomplete circumcision?
No. 54162 addresses adhesions. Code 54163 is the nearby code for repair of a circumcision; select based on the procedure actually performed.
Can modifier 50 be used for adhesions on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. 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
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