CPT code 54322: Urethral reconstruction2026 Medicare rate & RVUs in Nebraska

Reports the second operation in a staged hypospadias repair, reconstructing the urethral passage from tissue prepared during the earlier stage.

CMS RVU26DEffective Oct 1, 20261 payment locality

CMS doesn’t publish an office rate for 54322 in Nebraska.

—Office (non-facility)
$653.69Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 54322 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nebraska
  2. What 54322 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 54322 covers

This code represents the later operation in a planned staged repair of hypospadias. The surgeon uses tissue prepared during the first operation to form or complete the urethral passage; correction of associated chordee may also be performed. Pediatric urologists commonly perform this reconstruction in a hospital or ambulatory surgical setting, although the code is not limited to pediatric patients.

Select the code when the operative report documents a second-stage reconstruction, rather than a first-stage or one-stage repair. Documentation should identify the prior staged operation, the urethral reconstruction performed, and any chordee correction. The 90-day global period includes 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 multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons and team surgery are 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.

54322 in Nebraska

54322 office and facility rates by payment locality
Payment localityOfficeFacility
NebraskaUnavailable$653.69

How the 54322 rate is calculated

Each of 54322’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 · 54322

RVUs × geographic indexes × conversion factor

Work13.63

13.63 RVUs× 1.000 GPCI

Practice expense5.72

5.72 RVUs× 1.000 GPCI

Malpractice1.75

1.75 RVUs× 1.000 GPCI

Adjusted RVUs

21.1000

Conversion factor

$33.4009

Medicare rate

$704.76

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 54322

54322 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54322

Urethral reconstruction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 54322

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

54322 without 51 · national facility

$704.76

Urethral reconstruction

54322-51 · Second procedure: 50%

$352.38

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%).

When to use modifier 51

54322 compared with similar codes

Compare codes · National

4 codes, side by side

  • 54322

    Urethral reconstruction13.63 wRVU

    Not priced

  • 54308

    Urethral reconstruction12.3 wRVU

    Not priced

  • 54324

    Hypospadias repair17.11 wRVU

    Not priced

  • 54326

    Urethral reconstruction16.59 wRVU

    Not priced

How to choose

54308Urethral reconstruction
Choose 54308 for the first stage of a staged repair; 54322 represents the later reconstruction.
54324Hypospadias repair
54324 is a one-stage repair for hypospadias distal to midshaft. Use 54322 when the reconstruction is the second stage of a planned repair.
54326Urethral reconstruction
54326 is a one-stage repair for more proximal hypospadias, extending from midshaft toward the perineum. Code 54322 identifies a second-stage procedure.

54322 billing questions

How does this code differ from 54308?

54322 describes the later, second-stage operation in a staged hypospadias repair. Code 54308 is for the first stage.

Can chordee correction be part of this service?

Yes. The reconstruction may include chordee correction; the operative report should describe the work performed.

When is a one-stage hypospadias repair code more appropriate?

Use a one-stage repair code when the surgeon completes the reconstruction in a single operation, rather than returning for the planned second stage.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.

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
RVUs for 54322PPRRVU2026_Oct_nonQPP.csv, line 6,278 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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