Billing code 54340: Hypospadias repairMedicare rate & RVUs in Ohio
Reports the simple service level within the complicated hypospadias repair family when a urologist reconstructs the urethral opening and penile anatomy.
CMS doesn’t publish an office rate for 54340 in Ohio.
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 54340 covers
Code 54340 identifies the simple level within the complicated-repair group for hypospadias. A urologist uses it for operative reconstruction of the urethral opening and penile urethra in a patient with congenital hypospadias when the documented work fits this level rather than a more extensive repair. These procedures are commonly performed in an operating room, including for pediatric patients, though the code is not limited to children.
Select the code from the operative report’s description of the reconstruction and its extent, not from the diagnosis alone. Document the anatomy addressed, the repair performed, and the reason the work meets this complicated-repair category. The service has a 90-day global period, including the day-before preoperative visit and 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 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
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.
54340 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $506.81 |
How the 54340 rate is calculated
Each of 54340’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 · 54340
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.47Practice expense 4.90Malpractice 1.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54340
54340 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54340
Hypospadias repair
| 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 · 54340
Hypospadias repair
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
54340 without 51 · national facility
$520.72
Hypospadias repair
54340-51 · Second procedure: 50%
$260.36
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%).
54340 compared with similar codes
Compare codes
54340 vs 54344 vs 54348 vs 54352: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54344Hypospadias repair
- Choose 54340 for the simple level of complicated repair. Code 54344 is associated with urethral mobilization, so the operative report should support that additional work when selecting it.
- 54348Hypospadias repair
- This code describes a more extensive repair involving urethral mobilization and correction of chordee; 54340 represents the simple level in the complicated-repair group.
- 54352Hypospadias revision
- Use 54352 for revision of a prior hypospadias repair. Code 54340 describes a different repair level, not specifically revision of an earlier operation.
54340 billing questions
How is 54340 distinguished from 54344 or 54348?
These codes distinguish levels of work within complicated hypospadias repair. Use the code that matches the operative technique and extent documented; 54344 and 54348 describe more specific urethral mobilization or chordee-related work.
Does the 90-day global period include routine postoperative visits?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for a bilateral repair?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
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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