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Billing code 54322: Urethral reconstructionMedicare rate & RVUs

Reports the second operation in a staged hypospadias repair, reconstructing the urethral passage from tissue prepared during the earlier stage.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $704.76 for 54322 nationally in a facility.

Medicare rate · 54322

Urethral reconstruction

Swap in your local Medicare rate.

Work RVUs
13.63
Total RVUs
21.10
Global days
090

National rate · 2026

$704.76

Facility setting, before claim adjustments.

See every locality for 54322 → · 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 54322 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 54322 covers

This code represents the later operation in a planned staged repair of hypospadias. The surgeon uses tissue prepared during the first operation to form or complete the urethral passage; correction of associated chordee may also be performed. Pediatric urologists commonly perform this reconstruction in a hospital or ambulatory surgical setting, although the code is not limited to pediatric patients.

Select the code when the operative report documents a second-stage reconstruction, rather than a first-stage or one-stage repair. Documentation should identify the prior staged operation, the urethral reconstruction performed, and any chordee correction. The 90-day global period includes 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 multiple-procedure reduction. An assistant at surgery may be 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 54322 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

54322 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$655.51
Alaska*Unavailable$918.56
ArizonaUnavailable$690.42
ArkansasUnavailable$649.47
AtlantaUnavailable$720.93
AustinUnavailable$710.09
BakersfieldUnavailable$708.90
Baltimore/Surr. CntysUnavailable$739.84
BeaumontUnavailable$683.41
BrazoriaUnavailable$693.82

54322 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
54322 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 54322 rate is calculated

Each of 54322’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 · 54322

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.63Practice expense 5.72Malpractice 1.75

21.1000 adjusted RVUs×$33.4009 conversion factor=$704.76

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

Payment rules and modifiers for 54322

54322 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54322

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)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 · 54322

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

54322 without 51 · national facility

$704.76

Urethral reconstruction

54322-51 · Second procedure: 50%

$352.38

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

54322 compared with similar codes

Compare codes

54322 vs 54308 vs 54324 vs 54326: national Medicare rates

Swap in your local Medicare rate.

  • 54322
    Urethral reconstruction · 13.63 wRVU
    —
  • 54308
    Urethral reconstruction · 12.3 wRVU
    —
  • 54324
    Hypospadias repair · 17.11 wRVU
    —
  • 54326
    Urethral reconstruction · 16.59 wRVU
    —

How to choose

54308Urethral reconstruction
Choose 54308 for the first stage of a staged repair; 54322 represents the later reconstruction.
54324Hypospadias repair
54324 is a one-stage repair for hypospadias distal to midshaft. Use 54322 when the reconstruction is the second stage of a planned repair.
54326Urethral reconstruction
54326 is a one-stage repair for more proximal hypospadias, extending from midshaft toward the perineum. Code 54322 identifies a second-stage procedure.

Codes related to 54322

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

Codes related to 54322
CodeHow it relatesNational office range
Same family
54308Urethral reconstructionFirst-stage urethral reconstruction for hypospadias.No office rate
Used instead
54324Hypospadias repairOne-stage hypospadias reconstruction when the repair is completed in one operation.No office rate
54326Urethral reconstructionOne-stage hypospadias reconstruction for a different extent of involvement.No office rate

54322 billing questions

How does this code differ from 54308?

54322 describes the later, second-stage operation in a staged hypospadias repair. Code 54308 is for the first stage.

Can chordee correction be part of this service?

Yes. The reconstruction may include chordee correction; the operative report should describe the work performed.

When is a one-stage hypospadias repair code more appropriate?

Use a one-stage repair code when the surgeon completes the reconstruction in a single operation, rather than returning for the planned second stage.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are 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 54322PPRRVU2026_Oct_nonQPP.csv, line 6,278 (RVU26D)

Open CMS sourceHow we calculate rates

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