$201.41
The procedure is the same type of prepuce slit, but 54001 is for a patient other than a newborn; 54000 is for a newborn.
On this page
CMS RVU26D · Effective 2026-10-01
54000 Dorsal slit Medicare reimbursement rates in Delaware
Reports a dorsal slit of a newborn’s foreskin, with or without circumcision, to open a tight or constricting prepuce. Compare 54000 office and facility rates across CMS payment localities in Delaware.
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 54000 in Delaware?
Delaware 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
$165.62
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$103.91
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Urology procedure
About 54000: Newborn prepuce dorsal slit
Reports a dorsal slit of a newborn’s foreskin, with or without circumcision, to open a tight or constricting prepuce.
CPT 54000 describes a dorsal incision through the newborn’s prepuce to open the foreskin. It may be performed with or without circumcision, including when a constricting foreskin needs release. The service is typically performed by a physician in a hospital, birthing facility, or outpatient setting. The record should identify the patient as a newborn, the reason for the slit, and whether circumcision was also performed.
Choose this code for a newborn; code 54001 is the related code for a patient other than a newborn. The 10-day global period includes related postoperative visits during that period. 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 for this procedure. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 54000
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.55 · 31%
- Practice expense (office) RVU3.26 · 65%
- Malpractice RVU0.20 · 4%
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.
54000 compared with similar codes
Office rates for Delaware, from the same CMS release.
$150.49
This code describes newborn circumcision using a clamp or other device. Use 54000 when the documented service is a dorsal slit of the newborn’s prepuce.
$226.14
This code describes newborn circumcision by surgical excision. Code 54000 identifies a dorsal slit, which may be performed with or without circumcision.
Compare 54000 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
Delaware →
Office / nonfacility
$165.62
Facility
$103.91
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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 54000 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,235
- Code
- 54000
- Physician work
- 1.55
- Practice expense
- 3.26
- Malpractice
- 0.20
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.55 | × 1.005 | 1.5577 |
| Practice expense | 3.26 | × 0.988 | 3.2209 |
| Malpractice | 0.20 | × 0.899 | 0.1798 |
| Total RVUs | 4.9584 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$165.62
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.55 | 1.005 |
| Practice expense | 3.26 | 0.988 |
| Malpractice | 0.2 | 0.899 |
(1.55 × 1.005 + 3.26 × 0.988 + 0.2 × 0.899) × $33.4009 = $165.62
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.55 | 1.005 |
| Practice expense | 1.39 | 0.988 |
| Malpractice | 0.2 | 0.899 |
(1.55 × 1.005 + 1.39 × 0.988 + 0.2 × 0.899) × $33.4009 = $103.91
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.
54000 billing questions
How do I distinguish 54000 from 54001?
Use 54000 for a newborn and 54001 for a patient other than a newborn. The distinction is the patient’s status, not the reason for the dorsal slit.
Does the newborn have to undergo circumcision?
No. The code covers the dorsal slit whether or not circumcision is also performed. Document whether circumcision occurred.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be reported.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant or co-surgeon be reported?
An assistant at surgery is paid only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% 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 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.
6,23253865,,Cysto insj dev ischmc rmdlg,A,,3.02,89.00,,0.95,,0.39,92.41,4.36,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,23353866,,Cathj rmvl dev ischmc rmdlg,A,,1.44,2.73,,0.58,,0.19,4.36,2.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23453899,,Unlisted px urinary system,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23554000,,Slitting of prepuce,A,,1.55,3.26,,1.39,,0.20,5.01,3.14,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23654001,,Slitting of prepuce,A,,2.18,3.64,,1.43,,0.27,6.09,3.88,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23754015,,I&d penis deep,A,,5.23,2.41,NA,2.41,,0.66,8.30,8.30,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23854050,,Destruction penis lesion(s),A,,1.26,2.97,,1.50,,0.14,4.37,2.90,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503