$237.70
Both describe excisional circumcision; select 54160 for a newborn younger than 28 days and 54161 at 28 days or older.
On this page
CMS RVU26D · Effective 2026-10-01
54161 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$182.01
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Urology procedure
About 54161: Excisional circumcision, age 28 days or older
Reports surgical removal of the foreskin in a patient aged 28 days or older, using an excisional technique rather than a clamp or device.
This code is for circumcision performed by surgically excising the foreskin in a patient who is at least 28 days old. Urologists, pediatric surgeons, and other surgeons may perform it in an office procedure room or an operating room. Common clinical reasons include phimosis or recurrent inflammation of the foreskin; the record should identify the indication and the excisional approach.
Choose this code by the patient’s age and the method used, not simply by the fact that circumcision was performed. Document the age, indication, and operative work. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate for this procedure. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 54161
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.24 · 60%
- Practice expense (office) RVU1.76 · 32%
- Malpractice RVU0.42 · 8%
6.2K
Medicare services in 2024 · #1735 by national volume
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.
54161 compared with similar codes
Office rates for Modesto, from the same CMS release.
$157.19
This code is for a clamp- or device-based method with a regional penile block, rather than the excisional method reported with 54161.
No office rate
Code 54163 concerns repair of a prior circumcision, not the initial excisional removal of foreskin reported with 54161.
The same code, a different location
How does Modesto compare?
54161 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 54161
Office
Unavailable
Facility
$182.01
No comparable office rate is available.
Merced
California · 54161
Office
Unavailable
Facility
$182.01
No comparable office rate is available.
Napa
California · 54161
Office
Unavailable
Facility
$199.64
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 54161
Office
Unavailable
Facility
$189.47
No comparable office rate is available.
Redding
California · 54161
Office
Unavailable
Facility
$182.01
No comparable office rate is available.
Rest Of California
California · 54161
Office
Unavailable
Facility
$182.01
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 54161
Office
Unavailable
Facility
$186.56
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 54161
Office
Unavailable
Facility
$188.00
No comparable office rate is available.
Salinas
California · 54161
Office
Unavailable
Facility
$187.23
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 54161
Office
Unavailable
Facility
$189.38
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 54161
Office
Unavailable
Facility
$207.83
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 54161
Office
Unavailable
Facility
$207.35
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 54161
Office
Unavailable
Facility
$212.41
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 54161
Office
Unavailable
Facility
$210.46
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 54161
Office
Unavailable
Facility
$184.53
No comparable office rate is available.
Santa Cruz-Watsonville
California · 54161
Office
Unavailable
Facility
$189.44
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 54161
Office
Unavailable
Facility
$187.31
No comparable office rate is available.
Santa Rosa-Petaluma
California · 54161
Office
Unavailable
Facility
$191.17
No comparable office rate is available.
Stockton
California · 54161
Office
Unavailable
Facility
$182.01
No comparable office rate is available.
Vallejo
California · 54161
Office
Unavailable
Facility
$198.96
No comparable office rate is available.
Visalia
California · 54161
Office
Unavailable
Facility
$182.01
No comparable office rate is available.
Yuba City
California · 54161
Office
Unavailable
Facility
$182.01
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 54161
Office
Unavailable
Facility
$198.93
No comparable office rate is available.
Miami
Florida · 54161
Office
Unavailable
Facility
$204.89
No comparable office rate is available.
Chicago
Illinois · 54161
Office
Unavailable
Facility
$200.25
No comparable office rate is available.
Manhattan
New York · 54161
Office
Unavailable
Facility
$205.70
No comparable office rate is available.
Alaska*
Alaska · 54161
Office
Unavailable
Facility
$232.66
No comparable office rate is available.
Alabama
Alabama · 54161
Office
Unavailable
Facility
$167.60
No comparable office rate is available.
Arkansas
Arkansas · 54161
Office
Unavailable
Facility
$165.94
No comparable office rate is available.
Arizona
Arizona · 54161
Office
Unavailable
Facility
$177.19
No comparable office rate is available.
Colorado
Colorado · 54161
Office
Unavailable
Facility
$183.02
No comparable office rate is available.
Connecticut
Connecticut · 54161
Office
Unavailable
Facility
$190.67
No comparable office rate is available.
Delaware
Delaware · 54161
Office
Unavailable
Facility
$179.45
No comparable office rate is available.
Fort Lauderdale
Florida · 54161
Office
Unavailable
Facility
$193.13
No comparable office rate is available.
Rest Of Florida
Florida · 54161
Office
Unavailable
Facility
$185.50
No comparable office rate is available.
Atlanta
Georgia · 54161
Office
Unavailable
Facility
$185.12
No comparable office rate is available.
Rest Of Georgia
Georgia · 54161
Office
Unavailable
Facility
$177.38
No comparable office rate is available.
Hawaii, Guam
Hawaii · 54161
Office
Unavailable
Facility
$183.18
No comparable office rate is available.
Iowa
Iowa · 54161
Office
Unavailable
Facility
$167.58
No comparable office rate is available.
Idaho
Idaho · 54161
Office
Unavailable
Facility
$168.94
No comparable office rate is available.
East St. Louis
Illinois · 54161
Office
Unavailable
Facility
$190.55
No comparable office rate is available.
Rest Of Illinois
Illinois · 54161
Office
Unavailable
Facility
$183.82
No comparable office rate is available.
Suburban Chicago
Illinois · 54161
Office
Unavailable
Facility
$194.21
No comparable office rate is available.
Indiana
Indiana · 54161
Office
Unavailable
Facility
$169.53
No comparable office rate is available.
Kansas
Kansas · 54161
Office
Unavailable
Facility
$168.43
No comparable office rate is available.
Kentucky
Kentucky · 54161
Office
Unavailable
Facility
$173.32
No comparable office rate is available.
New Orleans
Louisiana · 54161
Office
Unavailable
Facility
$179.47
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 54161
Office
Unavailable
Facility
$173.68
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 54161
Office
Unavailable
Facility
$195.33
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 54161
Office
Unavailable
Facility
$183.03
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 54161
Office
Unavailable
Facility
$190.38
No comparable office rate is available.
Rest Of Maryland
Maryland · 54161
Office
Unavailable
Facility
$181.67
No comparable office rate is available.
Rest Of Maine
Maine · 54161
Office
Unavailable
Facility
$171.03
No comparable office rate is available.
Southern Maine
Maine · 54161
Office
Unavailable
Facility
$175.33
No comparable office rate is available.
Detroit
Michigan · 54161
Office
Unavailable
Facility
$188.60
No comparable office rate is available.
Rest Of Michigan
Michigan · 54161
Office
Unavailable
Facility
$177.73
No comparable office rate is available.
Minnesota
Minnesota · 54161
Office
Unavailable
Facility
$172.86
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 54161
Office
Unavailable
Facility
$177.12
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 54161
Office
Unavailable
Facility
$178.24
No comparable office rate is available.
Rest Of Missouri
Missouri · 54161
Office
Unavailable
Facility
$172.56
No comparable office rate is available.
Mississippi
Mississippi · 54161
Office
Unavailable
Facility
$169.20
No comparable office rate is available.
Montana**
Montana · 54161
Office
Unavailable
Facility
$181.00
No comparable office rate is available.
North Carolina
North Carolina · 54161
Office
Unavailable
Facility
$172.03
No comparable office rate is available.
North Dakota**
North Dakota · 54161
Office
Unavailable
Facility
$172.70
No comparable office rate is available.
Nebraska
Nebraska · 54161
Office
Unavailable
Facility
$167.78
No comparable office rate is available.
New Hampshire
New Hampshire · 54161
Office
Unavailable
Facility
$181.69
No comparable office rate is available.
Northern Nj
New Jersey · 54161
Office
Unavailable
Facility
$198.21
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 54161
Office
Unavailable
Facility
$192.13
No comparable office rate is available.
New Mexico
New Mexico · 54161
Office
Unavailable
Facility
$178.97
No comparable office rate is available.
Nevada**
Nevada · 54161
Office
Unavailable
Facility
$178.75
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 54161
Office
Unavailable
Facility
$211.09
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 54161
Office
Unavailable
Facility
$194.43
No comparable office rate is available.
Queens
New York · 54161
Office
Unavailable
Facility
$204.86
No comparable office rate is available.
Rest Of New York
New York · 54161
Office
Unavailable
Facility
$173.93
No comparable office rate is available.
Ohio
Ohio · 54161
Office
Unavailable
Facility
$176.03
No comparable office rate is available.
Oklahoma
Oklahoma · 54161
Office
Unavailable
Facility
$171.61
No comparable office rate is available.
Portland
Oregon · 54161
Office
Unavailable
Facility
$185.70
No comparable office rate is available.
Rest Of Oregon
Oregon · 54161
Office
Unavailable
Facility
$176.63
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 54161
Office
Unavailable
Facility
$188.10
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 54161
Office
Unavailable
Facility
$175.44
No comparable office rate is available.
Puerto Rico
Puerto Rico · 54161
Office
Unavailable
Facility
$181.47
No comparable office rate is available.
Rhode Island
Rhode Island · 54161
Office
Unavailable
Facility
$183.51
No comparable office rate is available.
South Carolina
South Carolina · 54161
Office
Unavailable
Facility
$174.46
No comparable office rate is available.
South Dakota**
South Dakota · 54161
Office
Unavailable
Facility
$171.72
No comparable office rate is available.
Tennessee
Tennessee · 54161
Office
Unavailable
Facility
$169.19
No comparable office rate is available.
Austin
Texas · 54161
Office
Unavailable
Facility
$183.06
No comparable office rate is available.
Beaumont
Texas · 54161
Office
Unavailable
Facility
$174.75
No comparable office rate is available.
Brazoria
Texas · 54161
Office
Unavailable
Facility
$178.28
No comparable office rate is available.
Dallas
Texas · 54161
Office
Unavailable
Facility
$179.78
No comparable office rate is available.
Fort Worth
Texas · 54161
Office
Unavailable
Facility
$179.37
No comparable office rate is available.
Galveston
Texas · 54161
Office
Unavailable
Facility
$179.07
No comparable office rate is available.
Houston
Texas · 54161
Office
Unavailable
Facility
$186.76
No comparable office rate is available.
Rest Of Texas
Texas · 54161
Office
Unavailable
Facility
$176.67
No comparable office rate is available.
Utah
Utah · 54161
Office
Unavailable
Facility
$176.07
No comparable office rate is available.
Virginia
Virginia · 54161
Office
Unavailable
Facility
$175.91
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 54161
Office
Unavailable
Facility
$181.47
No comparable office rate is available.
Vermont
Vermont · 54161
Office
Unavailable
Facility
$173.52
No comparable office rate is available.
Rest Of Washington
Washington · 54161
Office
Unavailable
Facility
$182.20
No comparable office rate is available.
Seattle (King Cnty)
Washington · 54161
Office
Unavailable
Facility
$197.22
No comparable office rate is available.
Wisconsin
Wisconsin · 54161
Office
Unavailable
Facility
$168.86
No comparable office rate is available.
West Virginia
West Virginia · 54161
Office
Unavailable
Facility
$179.38
No comparable office rate is available.
Wyoming**
Wyoming · 54161
Office
Unavailable
Facility
$177.39
No comparable office rate is available.
See how rates vary across the country
54161 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 54161 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$200.21
$182.01 × 110% = $200.21
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 54161 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
6,256
- Code
- 54161
- Physician work
- 3.24
- Practice expense
- 1.76
- Malpractice
- 0.42
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.24 | × 1.017 | 3.2951 |
| Practice expense | 1.76 | × 1.096 | 1.9290 |
| Malpractice | 0.42 | × 0.536 | 0.2251 |
| Total RVUs | 5.4492 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$182.01
Open 54161 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.24 | 1.017 |
| Practice expense | 1.76 | 1.096 |
| Malpractice | 0.42 | 0.536 |
(3.24 × 1.017 + 1.76 × 1.096 + 0.42 × 0.536) × $33.4009 = $182.01
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
54161 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $182.01 | RVU26D |
| 2026-07-01 | Not available in this setting | $182.01 | RVU26C |
| 2026-04-01 | Not available in this setting | $182.01 | RVU26B |
| 2026-01-01 | Not available in this setting | $182.01 | RVU26A |
| 2025-10-01 | Not available in this setting | $195.69 | RVU25D |
| 2025-07-01 | Not available in this setting | $195.69 | RVU25C |
| 2025-04-01 | Not available in this setting | $195.69 | RVU25B |
| 2025-01-01 | Not available in this setting | $195.69 | RVU25A |
54161 billing questions
How does this differ from circumcision code 54160?
Code 54161 is for excisional circumcision at age 28 days or older. Code 54160 is the excisional circumcision code for a newborn younger than 28 days.
When should 54150 be considered instead?
Code 54150 describes circumcision using a clamp or other device with a regional penile block. Use 54161 when the documented method is surgical excision in a patient at least 28 days old.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are paid at 50% under the standard multiple procedure reduction.
Can modifier 50 or an assistant-at-surgery service be reported?
Modifier 50 is inappropriate for this procedure. Assistant-at-surgery services are not paid, and 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,25354135,,Remove penis & nodes,A,,27.47,9.24,NA,9.24,,3.54,40.25,40.25,0,090,0.10,0.80,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25454150,,Circumcision w/regionl block,A,,1.85,2.46,,0.43,,0.24,4.55,2.52,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25554160,,Circumcision neonate,A,,2.47,4.04,,1.16,,0.33,6.84,3.96,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25654161,,Circum 28 days or older,A,,3.24,1.76,NA,1.76,,0.42,5.42,5.42,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25754162,,Lysis penil circumic lesion,A,,3.24,4.25,,1.86,,0.42,7.91,5.52,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25854163,,Repair of circumcision,A,,3.24,2.54,NA,2.54,,0.42,6.20,6.20,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,25954164,,Frenulotomy of penis,A,,2.75,2.44,NA,2.44,,0.36,5.55,5.55,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536