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Billing code 54340: Hypospadias repairMedicare rate & RVUs

Reports the simple service level within the complicated hypospadias repair family when a urologist reconstructs the urethral opening and penile anatomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $520.72 for 54340 nationally in a facility.

Medicare rate · 54340

Hypospadias repair

Work RVUs
9.47
Total RVUs
15.59
Global days
090

National rate · 2026

$520.72

Facility setting, before claim adjustments.

See every locality for 54340 →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 54340 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 54340 covers

Code 54340 identifies the simple level within the complicated-repair group for hypospadias. A urologist uses it for operative reconstruction of the urethral opening and penile urethra in a patient with congenital hypospadias when the documented work fits this level rather than a more extensive repair. These procedures are commonly performed in an operating room, including for pediatric patients, though the code is not limited to children.

Select the code from the operative report’s description of the reconstruction and its extent, not from the diagnosis alone. Document the anatomy addressed, the repair performed, and the reason the work meets this complicated-repair category. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.

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 54340 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

54340 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$482.58
Alaska*Unavailable$671.22
ArizonaUnavailable$509.78
ArkansasUnavailable$477.88
AtlantaUnavailable$532.48
AustinUnavailable$526.20
BakersfieldUnavailable$526.51
Baltimore/Surr. CntysUnavailable$547.39
BeaumontUnavailable$503.10
BrazoriaUnavailable$512.81

54340 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
54340 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 54340 rate is calculated

Each of 54340’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 · 54340

RVUs × geographic indexes × conversion factor

Work9.47

9.47 RVUs× 1.000 GPCI

Practice expense4.90

4.90 RVUs× 1.000 GPCI

Malpractice1.22

1.22 RVUs× 1.000 GPCI

Adjusted RVUs

15.5900

Conversion factor

$33.4009

Medicare rate

$520.72

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

Payment rules and modifiers for 54340

54340 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54340

Hypospadias repair

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 · 54340

Hypospadias repair

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

54340 without 51 · national facility

$520.72

Hypospadias repair

54340-51 · Second procedure: 50%

$260.36

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

54340 compared with similar codes

Compare codes · National

4 codes, side by side

  • 54340

    Hypospadias repair9.47 wRVU

    Not priced

  • 54344

    Hypospadias repair16.63 wRVU

    Not priced

  • 54348

    Hypospadias repair17.86 wRVU

    Not priced

  • 54352

    Hypospadias revision25.48 wRVU

    Not priced

How to choose

54344Hypospadias repair
Choose 54340 for the simple level of complicated repair. Code 54344 is associated with urethral mobilization, so the operative report should support that additional work when selecting it.
54348Hypospadias repair
This code describes a more extensive repair involving urethral mobilization and correction of chordee; 54340 represents the simple level in the complicated-repair group.
54352Hypospadias revision
Use 54352 for revision of a prior hypospadias repair. Code 54340 describes a different repair level, not specifically revision of an earlier operation.

Codes related to 54340

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

Codes related to 54340
CodeHow it relatesNational office range
Same family
54344Hypospadias repairA related complicated-repair level involving urethral mobilization.No office rate
54348Hypospadias repairA related level involving urethral mobilization and chordee correction.No office rate
Used instead
54352Hypospadias revisionFor revision of a prior hypospadias repair rather than the simple level represented here.No office rate

54340 billing questions

How is 54340 distinguished from 54344 or 54348?

These codes distinguish levels of work within complicated hypospadias repair. Use the code that matches the operative technique and extent documented; 54344 and 54348 describe more specific urethral mobilization or chordee-related work.

Does the 90-day global period include routine postoperative visits?

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

Can modifier 50 be used for a bilateral repair?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.

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 54340PPRRVU2026_Oct_nonQPP.csv, line 6,284 (RVU26D)

Open CMS sourceHow we calculate rates

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