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Billing code 54163: Circumcision repairMedicare rate & RVUs

Surgical revision of a prior circumcision to correct residual foreskin or an unsatisfactory result when operative repair, rather than initial circumcision, is performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities157 Medicare services in 2024

Medicare pays $207.09 for 54163 nationally in a facility.

Medicare rate · 54163

Circumcision repair

Work RVUs
3.24
Total RVUs
6.20
Global days
010

National rate · 2026

$207.09

Facility setting, before claim adjustments.

See every locality for 54163 →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 54163 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 54163 covers

This service revises anatomy after an earlier circumcision, such as correcting residual foreskin or an irregular result that requires surgical repair. A urologist or pediatric urologist typically performs the procedure in an operating room or ambulatory surgery setting. It is distinct from performing a circumcision for the first time and from treating an isolated adhesion or frenular problem.

Report 54163 when the operative service repairs a prior circumcision, not merely because circumcision appears in the history. The record should identify the prior procedure, the specific defect or residual tissue, and the repair performed. The 10-day global period includes related postoperative visits during that period. 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. Medicare does not pay an assistant at surgery for this service; 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 54163 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

54163 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$190.39
Alaska*Unavailable$260.41
ArizonaUnavailable$202.44
ArkansasUnavailable$188.32
AtlantaUnavailable$211.59
AustinUnavailable$210.62
BakersfieldUnavailable$211.80
Baltimore/Surr. CntysUnavailable$218.34
BeaumontUnavailable$198.45
BrazoriaUnavailable$204.10

54163 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.

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54163 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 54163 rate is calculated

Each of 54163’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 · 54163

RVUs × geographic indexes × conversion factor

Work3.24

3.24 RVUs× 1.000 GPCI

Practice expense2.54

2.54 RVUs× 1.000 GPCI

Malpractice0.42

0.42 RVUs× 1.000 GPCI

Adjusted RVUs

6.2000

Conversion factor

$33.4009

Medicare rate

$207.09

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 54163

54163 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54163

Circumcision repair

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 · 54163

Circumcision repair

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

54163 without 51 · national facility

$207.09

Circumcision repair

54163-51 · Second procedure: 50%

$103.55

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

54163 compared with similar codes

Compare codes · National

5 codes, side by side

  • 54163

    Circumcision repair3.24 wRVU

    Not priced

  • 54160

    Circumcision2.47 wRVU

    $228.46

  • 54161

    Circumcision3.24 wRVU

    Not priced

  • 54162

    Penile adhesion lysis3.24 wRVU

    $264.20

  • 54164

    Frenulotomy2.75 wRVU

    Not priced

How to choose

54160Circumcision
54160 is an initial circumcision procedure for a neonate. Use 54163 when the service surgically corrects a prior circumcision.
54161Circumcision
54161 is an initial circumcision procedure for a patient 28 days or older. It does not describe revision of a prior circumcision.
54162Penile adhesion lysis
54162 describes lysis of penile adhesions. Choose 54163 when the operative target is repair of the circumcision result rather than isolated adhesion release.
54164Frenulotomy
54164 describes a penile frenulotomy. Choose 54163 for repair of a circumcision defect, not an isolated frenular procedure.

Codes related to 54163

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

Codes related to 54163
CodeHow it relatesNational office range
Used instead
54160CircumcisionFor an initial circumcision in a neonate, rather than repair of a prior circumcision.$204.09–$292.07
54161CircumcisionFor an initial circumcision at age 28 days or older, rather than repair.No office rate
54162Penile adhesion lysisFor lysis of penile adhesions when adhesion release, not circumcision repair, is performed.$237.38–$332.34
54164FrenulotomyFor frenulotomy when the procedure addresses the penile frenulum rather than a circumcision defect.No office rate

54163 billing questions

How is repair different from a new circumcision?

Use 54163 for operative correction after a prior circumcision. Codes 54160 and 54161 describe circumcision procedures, not repair of an earlier result.

Is isolated penile adhesion release reported as a circumcision repair?

No. Code 54162 describes lysis of penile adhesions; 54163 is for repair of the circumcision itself.

What documentation supports 54163?

Document the prior circumcision, the specific residual tissue or other defect, and the operative steps used to correct it.

Are related postoperative visits included?

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

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for 54163.

Can co-surgeons or a surgical team report the repair?

No. CMS lists co-surgeons and team surgery as not permitted for this code.

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 54163PPRRVU2026_Oct_nonQPP.csv, line 6,258 (RVU26D)

Open CMS sourceHow we calculate rates

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