Billing code 54336: Hypospadias repairMedicare rate & RVUs in Delaware
Reports the second operation in a staged reconstruction for severe, previously operated hypospadias when the surgeon completes urethral reconstruction.
CMS doesn’t publish an office rate for 54336 in Delaware.
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 9 sections
What 54336 covers
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.
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 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,055.63 |
How the 54336 rate is calculated
Each of 54336’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 · 54336
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.08Practice expense 8.08Malpractice 2.71
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54336
54336 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54336
Hypospadias repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54336
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
54336 without 51 · national facility
$1,064.49
Hypospadias repair
54336-51 · Second procedure: 50%
$532.25
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%).
54336 compared with similar codes
Compare codes
54336 vs 54332 vs 54328 vs 54352 vs 54340: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54332Penile revision
- 54332 is the first-stage procedure in the crippled-state staged reconstruction; 54336 is the second-stage completion.
- 54328Penile reconstruction
- 54328 describes a one-stage crippled-state repair. Choose 54336 when the documented operation completes a two-stage reconstruction.
- 54352Hypospadias revision
- 54352 is used for revision of a prior hypospadias repair. 54336 is specific to the second stage of a crippled-state reconstruction.
- 54340Hypospadias repair
- 54340 addresses complicated hypospadias repair, such as repair involving a fistula or stricture; 54336 describes the second stage of crippled-state reconstruction.
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 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
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