No office rate
This code addresses bladder exstrophy together with epispadias. Code 54380 is an epispadias repair for a different operative scope.
On this page
CMS RVU26D · Effective 2026-10-01
54390 Genital reconstruction Medicare reimbursement rates in Nebraska
Reports complex reconstructive surgery addressing epispadias together with bladder exstrophy, involving repair of the bladder and associated penile anatomy. Compare 54390 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 54390 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
$1029.79
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.
Urologic surgery
About 54390: Epispadias and bladder exstrophy repair
Reports complex reconstructive surgery addressing epispadias together with bladder exstrophy, involving repair of the bladder and associated penile anatomy.
This code describes a major reconstructive operation for bladder exstrophy with epispadias, a congenital condition involving an exposed bladder and abnormal development of the penis and urethra. The operation addresses the bladder and penile anatomy as part of the same reconstruction. Pediatric urologists typically perform it in a hospital operating room; the clinical record should establish the combined anatomic problem and the reconstructive work performed.
Report the code when the operative service matches this combined repair, rather than an isolated epispadias repair or a urethral reconstruction for a different defect. The operative report should document the bladder and penile findings and the procedures performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 54390
- 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 RVU22.20 · 67%
- Practice expense (office) RVU8.18 · 25%
- Malpractice RVU2.86 · 9%
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.
54390 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Use 54390 for the combined bladder exstrophy and epispadias repair; distinguish 54385 by the specific epispadias operation documented.
No office rate
Code 54308 describes anterior urethral reconstruction. It is not the combined bladder and penile reconstruction represented by 54390.
Compare 54390 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
$1029.79
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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 54390 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
6,291
- Code
- 54390
- Physician work
- 22.20
- Practice expense
- 8.18
- Malpractice
- 2.86
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.20 | × 1.000 | 22.2000 |
| Practice expense | 8.18 | × 0.923 | 7.5501 |
| Malpractice | 2.86 | × 0.378 | 1.0811 |
| Total RVUs | 30.8312 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$1029.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.2 | 1 |
| Practice expense | 8.18 | 0.923 |
| Malpractice | 2.86 | 0.378 |
(22.2 × 1 + 8.18 × 0.923 + 2.86 × 0.378) × $33.4009 = $1029.79
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.
54390 billing questions
When should this code be chosen over a code for epispadias repair alone?
Use this code when the operation repairs bladder exstrophy together with the associated epispadias. An isolated epispadias repair without bladder exstrophy is a different service.
Does the 90-day global period include routine postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
What should the operative report establish?
Document the bladder exstrophy and associated epispadias, the anatomy addressed, and the reconstructive work performed on the bladder and penis.
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.
6,28854360,,Penis plastic surgery,A,,12.46,5.48,NA,5.48,,1.61,19.55,19.55,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,28954380,,Repair penis,A,,13.83,6.06,NA,6.06,,1.77,21.66,21.66,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,29054385,,Repair penis,A,,16.15,6.92,NA,6.92,,2.08,25.15,25.15,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,29154390,,Repair penis and bladder,A,,22.20,8.18,NA,8.18,,2.86,33.24,33.24,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,29254400,,Insert semi-rigid prosthesis,A,,8.94,4.43,NA,4.43,,1.15,14.52,14.52,0,090,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,29354401,,Insert self-contd prosthesis,A,,10.18,7.00,NA,7.00,,1.31,18.49,18.49,0,090,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,29454405,,Insert multi-comp penis pros,A,,14.16,5.84,NA,5.84,,1.82,21.82,21.82,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,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