No office rate
This code is for the later operation completing a staged reconstruction; 54316 is used for the initial stage.
On this page
CMS RVU26D · Effective 2026-10-01
54318 Urethral reconstruction Medicare reimbursement rates in Nebraska
Reports the later operation in a planned two-stage reconstruction of the male anterior urethra, typically closing the urethral opening created during the first stage. Compare 54318 office and facility rates across CMS payment localities in Nebraska.
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 54318 in Nebraska?
Nebraska 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
$600.24
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 surgery
About 54318: Second-stage urethral reconstruction
Reports the later operation in a planned two-stage reconstruction of the male anterior urethra, typically closing the urethral opening created during the first stage.
This code represents the planned second operation in a staged reconstruction of the male anterior urethra. The surgeon completes the urethral channel using tissue shaped or prepared during the initial operation, often closing a temporary urethral opening. Urologists typically perform the procedure in an operating room when a urethral defect or stricture is managed in stages rather than reconstructed in one operation.
Report it for the second stage, not for the initial preparation or a one-stage repair. The operative report should identify the prior staged reconstruction and describe the work completing the urethra. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 54318
- 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 RVU12.12 · 63%
- Practice expense (office) RVU5.70 · 29%
- Malpractice RVU1.56 · 8%
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.
54318 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Use 54308 for a one-stage urethral reconstruction. This code is for the planned second operation in a two-stage repair.
No office rate
54324 is a hypospadias repair code. Select the code that matches the documented condition and operative repair rather than treating it as a general second-stage urethral reconstruction code.
Compare 54318 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$600.24
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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 54318 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
6,277
- Code
- 54318
- Physician work
- 12.12
- Practice expense
- 5.70
- Malpractice
- 1.56
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.12 | × 1.000 | 12.1200 |
| Practice expense | 5.70 | × 0.923 | 5.2611 |
| Malpractice | 1.56 | × 0.378 | 0.5897 |
| Total RVUs | 17.9708 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$600.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.12 | 1 |
| Practice expense | 5.7 | 0.923 |
| Malpractice | 1.56 | 0.378 |
(12.12 × 1 + 5.7 × 0.923 + 1.56 × 0.378) × $33.4009 = $600.24
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.
54318 billing questions
How is this distinguished from the first-stage operation?
Use this code for the planned later operation that completes the urethral reconstruction. The first-stage procedure prepares the tissue or creates the opening used for that later repair.
Can it be reported for a one-stage urethral reconstruction?
No. This code represents the second stage of a planned two-stage reconstruction; a one-stage reconstruction belongs to the applicable one-stage code.
What documentation supports reporting the second stage?
Document the prior staged reconstruction, the current operative work completing the urethra, and the relationship between the two stages.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral work?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made, co-surgeons require supporting documentation, and 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.
6,27454308,,Reconstruction of urethra,A,,12.30,5.55,NA,5.55,,1.58,19.43,19.43,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,27554312,,Reconstruction of urethra,A,,14.15,6.21,NA,6.21,,1.82,22.18,22.18,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,27654316,,Reconstruction of urethra,A,,17.60,6.87,NA,6.87,,2.26,26.73,26.73,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,27754318,,Reconstruction of urethra,A,,12.12,5.70,NA,5.70,,1.56,19.38,19.38,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,27854322,,Reconstruction of urethra,A,,13.63,5.72,NA,5.72,,1.75,21.10,21.10,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,27954324,,Reconstruction of urethra,A,,17.11,6.74,NA,6.74,,2.19,26.04,26.04,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,28054326,,Reconstruction of urethra,A,,16.59,6.66,NA,6.66,,2.13,25.38,25.38,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068