$209.55–$222.01
54160 describes neonatal circumcision. Use 54162 for release or removal of post-circumcision adhesions, not for circumcision itself.
On this page
CMS RVU26D · Effective 2026-10-01
54162 Penile adhesion lysis Medicare reimbursement rates in Missouri
Reports release or excision of adhesions between penile skin and the glans after circumcision, commonly performed in an office or outpatient setting. Compare 54162 office and facility rates across CMS payment localities in Missouri.
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 54162 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$244.25–$257.42
3 of 3 localities have a supported rate.
Facility setting
$175.43–$181.42
3 of 3 localities have a supported rate.
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.
Where 54162 pays more and less in Missouri
3 payment localities
$244.25 to $257.42
Urology procedure
About 54162: Lysis of penile post-circumcision adhesions
Reports release or excision of adhesions between penile skin and the glans after circumcision, commonly performed in an office or outpatient setting.
This service releases or removes penile adhesions that have formed after circumcision, separating skin attached to the glans. Urologists and other clinicians who perform penile procedures may treat these adhesions in an office or outpatient setting. The operative target is the adhesion itself, rather than a new circumcision, repair of an incomplete circumcision, or release of the frenulum.
Report the code when the documented procedure is lysis or excision of post-circumcision penile adhesions. The record should identify the adhesions and describe the release or removal performed. The service has a 10-day global period, so related postoperative visits during that period are included. 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 multiple-procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 54162
- 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 · 41%
- Practice expense (office) RVU4.25 · 54%
- Malpractice RVU0.42 · 5%
293
Medicare services in 2024 · #4010 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.
54162 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
54161 is the circumcision code for patients 28 days or older. 54162 addresses adhesions after circumcision.
No office rate
54163 is for repair of a circumcision; 54162 is for lysis or excision of penile adhesions.
No office rate
54164 treats a penile frenulum. Use 54162 when the structure being released is an adhesion between penile skin and the glans.
Compare 54162 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$255.22
Facility
$180.26
Metropolitan St. Louis →
Office / nonfacility
$257.42
Facility
$181.42
Rest Of Missouri →
Office / nonfacility
$244.25
Facility
$175.43
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54162 billing questions
When should 54162 be chosen instead of a circumcision code?
Use 54162 when the service releases or removes adhesions between penile skin and the glans after circumcision. Choose a circumcision code when circumcision itself is performed.
Is 54162 the code for correcting an incomplete circumcision?
No. 54162 addresses adhesions. Code 54163 is the nearby code for repair of a circumcision; select based on the procedure actually performed.
Can modifier 50 be used for adhesions on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. 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.
6,25454150,,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
6,26054200,,Injection px peyronie ds,A,,1.08,2.41,,1.28,,0.14,3.63,2.50,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00