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CMS RVU26D · Effective 2026-10-01

54336 Hypospadias repair Medicare reimbursement rates in Connecticut

Reports the second operation in a staged reconstruction for severe, previously operated hypospadias when the surgeon completes urethral reconstruction. Compare 54336 office and facility rates across CMS payment localities in Connecticut.

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.

What does Medicare pay for 54336 in Connecticut?

Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1118.36

1 of 1 localities have a supported rate.

Payment area: Connecticut

One mapped payment locality.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 54336 in your payment locality →

Urologic surgery

About 54336: Second-stage crippled-state hypospadias repair

Reports the second operation in a staged reconstruction for severe, previously operated hypospadias when the surgeon completes urethral reconstruction.

A urologist uses this code for the second stage of reconstructing severe hypospadias in a previously operated or otherwise extensively damaged penis. After the first-stage procedure has prepared tissue for reconstruction, the surgeon completes the urethral repair, typically by forming a urethral channel from the prepared tissue. This is major reconstructive surgery, generally performed in an operating room rather than as a minor office correction.

Report the code for the second-stage operation, not the preparatory first stage or a one-stage repair. The operative report should establish the history and severity of the prior repair, the staged plan, and the reconstructive work completed at this operation. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the global period. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 54336

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU21.08 · 66%
  • Practice expense (office) RVU8.08 · 25%
  • Malpractice RVU2.71 · 9%

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.

54336 compared with similar codes

Office rates for Connecticut, from the same CMS release.

54332

Penile revision

Penis and urethra

No office rate

54332 is the first-stage procedure in the crippled-state staged reconstruction; 54336 is the second-stage completion.

54328

Penile reconstruction

Penis and urethra

No office rate

54328 describes a one-stage crippled-state repair. Choose 54336 when the documented operation completes a two-stage reconstruction.

54352

Hypospadias revision

Previously repaired hypospadias

No office rate

54352 is used for revision of a prior hypospadias repair. 54336 is specific to the second stage of a crippled-state reconstruction.

54340

Hypospadias repair

Complicated group, simple level

No office rate

54340 addresses complicated hypospadias repair, such as repair involving a fistula or stricture; 54336 describes the second stage of crippled-state reconstruction.

Compare 54336 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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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 54336 in Connecticut.

PPRRVU2026_Oct_nonQPP.csv

6,283

Code
54336
Physician work
21.08
Practice expense
8.08
Malpractice
2.71

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 54336 in Connecticut
ComponentRVULocality factorAdjusted
Physician work21.08× 1.02021.5016
Practice expense8.08× 1.0778.7022
Malpractice2.71× 1.2103.2791
Total RVUs33.4829
Conversion factor× 33.4009

Facility rate, Connecticut$1118.36

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work21.081.02
Practice expense8.081.077
Malpractice2.711.21

(21.08 × 1.02 + 8.08 × 1.077 + 2.71 × 1.21) × $33.4009 = $1118.36

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.

54336 billing questions

When should 54336 be reported instead of 54332?

Use 54336 for the second-stage operation in a staged crippled-state hypospadias reconstruction. Code 54332 describes the first stage.

How does 54336 differ from 54328?

54336 is for the second stage of a two-stage reconstruction. 54328 describes a one-stage repair in the crippled state.

What documentation supports the second-stage code?

Document the prior repair and resulting severity, the staged reconstruction plan, and the operative work that completes the urethral reconstruction.

Are the preoperative and postoperative visits separately included?

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

Can modifier 50 be used for bilateral work?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while 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 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.

RVUs for 54336PPRRVU2026_Oct_nonQPP.csv, line 6,283 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)