CPT code 54326: Urethral reconstruction2026 Medicare rate & RVUs in Illinois
Reports one-stage reconstruction for severe perineal hypospadias, when the surgeon creates a urethral channel from the perineal opening toward the glans.
CMS doesn’t publish an office rate for 54326 in Illinois.
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 54326 covers
This code describes a one-stage operation for severe hypospadias in which the urethral opening is in the perineum. The surgeon reconstructs the urethral passage, using extensive dissection and mobilization of the urethral plate. A urologist typically performs the procedure in an operating room, often for a child with a congenital urethral opening well proximal to the penile shaft. The operative report should identify the original meatus location and describe the reconstruction performed.
Choose this code for the perineal presentation, rather than a repair classified by a distal or proximal penile meatus. Documentation should support the anatomy and the extent of reconstruction. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery services 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.
Where 54326 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $944.84 |
| East St. Louis | Unavailable | $902.06 |
| Rest Of Illinois | Unavailable | $868.42 |
| Suburban Chicago | Unavailable | $912.52 |
How the 54326 rate is calculated
Each of 54326’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 · 54326
RVUs × geographic indexes × conversion factor
Work16.59
16.59 RVUs× 1.000 GPCI
Practice expense6.66
6.66 RVUs× 1.000 GPCI
Malpractice2.13
2.13 RVUs× 1.000 GPCI
Adjusted RVUs
25.3800
Conversion factor
$33.4009
Medicare rate
$847.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54326
54326 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54326
Urethral reconstruction
| 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 · 54326
Urethral reconstruction
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
54326 without 51 · national facility
$847.71
Urethral reconstruction
54326-51 · Second procedure: 50%
$423.86
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%).
54326 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 54322Urethral reconstruction
- 54322 is for a distal penile hypospadias presentation. Use 54326 when the urethral opening is perineal.
- 54324Hypospadias repair
- 54324 addresses proximal penile hypospadias; 54326 identifies the more proximal, perineal presentation.
- 54344Hypospadias repair
- 54344 is for correction of a hypospadias repair complication, not the primary perineal reconstruction reported with 54326.
- 54352Hypospadias revision
- 54352 is for revision of a prior hypospadias repair. Use 54326 for the primary one-stage perineal reconstruction.
54326 billing questions
How is this code distinguished from 54324?
54326 is selected for perineal hypospadias. Code 54324 is for a proximal penile presentation; document the location of the urethral opening.
What documentation supports reporting 54326?
The operative report should establish that the meatus is perineal and describe the extensive dissection, urethral plate mobilization, and reconstruction performed.
Are related postoperative visits separately reported during the global period?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.
How is 54326 treated when another procedure is performed in the same session?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.
Can 54326 be reported for a repair of a prior hypospadias operation?
Use a code for revision or repair of a complication when the operative purpose is to address a prior repair, rather than to perform the primary perineal reconstruction represented by 54326.
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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