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Billing code 54316: Urethral reconstructionMedicare rate & RVUs

Reports the second operation in a planned two-stage reconstruction of the male anterior urethra, after the initial stage has prepared tissue for completion.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $892.81 for 54316 nationally in a facility.

Medicare rate · 54316

Urethral reconstruction

Swap in your local Medicare rate.

Work RVUs
17.6
Total RVUs
26.73
Global days
090

National rate · 2026

$892.81

Facility setting, before claim adjustments.

See every locality for 54316 → · 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 54316 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 54316 covers

This operation completes a planned two-stage reconstruction of the male anterior urethra. The urologist uses tissue prepared during the first stage to form or complete a urethral channel, commonly in a complex reconstruction after severe congenital abnormality or prior urethral surgery. It is performed in an operating room, with the operative report identifying the reconstructed segment and the work performed to complete the staged repair.

Report this code when the operative plan and documentation establish that this is the second stage of anterior urethral reconstruction, not a one-stage repair or the initial stage. Documentation should identify the prior first-stage work and the current reconstruction. CMS 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. Assistant-at-surgery payment may be made; 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 54316 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

54316 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$831.36
Alaska*Unavailable$1,167.76
ArizonaUnavailable$874.82
ArkansasUnavailable$823.84
AtlantaUnavailable$913.41
AustinUnavailable$898.69
BakersfieldUnavailable$896.49
Baltimore/Surr. CntysUnavailable$936.85
BeaumontUnavailable$866.79
BrazoriaUnavailable$878.84

54316 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
54316 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 54316 rate is calculated

Each of 54316’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 · 54316

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.60Practice expense 6.87Malpractice 2.26

26.7300 adjusted RVUs×$33.4009 conversion factor=$892.81

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

Payment rules and modifiers for 54316

54316 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54316

Urethral reconstruction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 54316

Urethral reconstruction

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

54316 without 51 · national facility

$892.81

Urethral reconstruction

54316-51 · Second procedure: 50%

$446.41

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

54316 compared with similar codes

Compare codes

54316 vs 54312 vs 54308 vs 54324: national Medicare rates

Swap in your local Medicare rate.

  • 54316
    Urethral reconstruction · 17.6 wRVU
    —
  • 54312
    Urethral reconstruction · 14.15 wRVU
    —
  • 54308
    Urethral reconstruction · 12.3 wRVU
    —
  • 54324
    Hypospadias repair · 17.11 wRVU
    —

How to choose

54312Urethral reconstruction
54312 is for the initial stage of the planned two-stage reconstruction; 54316 is for its completion.
54308Urethral reconstruction
54308 represents a one-stage anterior urethral reconstruction. Use 54316 when the documented operation is the second stage of a planned staged repair.
54324Hypospadias repair
54324 is a hypospadias repair code. Distinguish it from 54316 by the specific operation documented and the applicable billing code descriptor.

Codes related to 54316

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

Codes related to 54316
CodeHow it relatesNational office range
Same family
54312Urethral reconstructionFirst stage of the planned two-stage anterior urethral reconstruction.No office rate
54318Urethral reconstructionRelated urethral reconstruction code; distinguish by the documented operative technique.No office rate
54322Urethral reconstructionRelated urethral reconstruction code; select based on the specific procedure performed.No office rate
Used instead
54308Urethral reconstructionOne-stage anterior urethral reconstruction rather than completion of a staged repair.No office rate

54316 billing questions

How does this differ from 54312?

54312 reports the first stage of a planned two-stage anterior urethral reconstruction. Report 54316 for the later operation that completes the reconstruction.

When would 54308 be considered instead?

54308 describes a one-stage anterior urethral reconstruction. The operative plan and work performed determine whether the repair is completed in one operation or as the second stage of a staged reconstruction.

What documentation supports reporting 54316?

The operative report should establish the staged reconstruction, identify the prior first-stage work, and describe the current procedure completing the urethral reconstruction.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inapplicable to this code, and modifier 50 is inappropriate.

How are other procedures in the same session paid?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.

Is assistant or co-surgeon billing allowed?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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
RVUs for 54316PPRRVU2026_Oct_nonQPP.csv, line 6,276 (RVU26D)

Open CMS sourceHow we calculate rates

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