No office rate
Choose 54322 for a more distal-to-midpenile opening. This code applies to a midshaft-to-proximal penile opening.
On this page
CMS RVU26D · Effective 2026-10-01
54324 Hypospadias repair Medicare reimbursement rates in Utah
One-stage reconstruction for hypospadias with a midshaft or proximal penile opening, reported when the surgeon repairs the urethra in a single operation. Compare 54324 office and facility rates across CMS payment localities in Utah.
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 54324 in Utah?
Utah 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
$848.79
1 of 1 localities have a supported rate.
Payment area: Utah
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 54324: One-stage proximal penile hypospadias repair
One-stage reconstruction for hypospadias with a midshaft or proximal penile opening, reported when the surgeon repairs the urethra in a single operation.
A pediatric urologist typically performs this operation for congenital hypospadias when the urethral opening is along the midshaft or proximal penile portion. The surgeon reconstructs the urethral channel in one operation; the procedure may also address associated penile curvature or provide tissue coverage as part of the reconstruction. It is generally performed in an operating room under anesthesia.
Select this code when the documented opening location and completed one-stage reconstruction match this service, rather than a repair for a more distal or perineal opening or a staged repair. The operative report should identify the meatal location, describe the urethral reconstruction, and establish that it was completed in one operation. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 54324
- 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 RVU17.11 · 66%
- Practice expense (office) RVU6.74 · 26%
- Malpractice RVU2.19 · 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.
54324 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
Choose 54326 when the opening is perineal; this code addresses a midshaft-to-proximal penile opening.
No office rate
54328 is used for a staged hypospadias repair approach. This code represents reconstruction completed in one operation.
Compare 54324 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
Utah →
Office / nonfacility
Unavailable
Facility
$848.79
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 54324 in Utah.
PPRRVU2026_Oct_nonQPP.csv
6,279
- Code
- 54324
- Physician work
- 17.11
- Practice expense
- 6.74
- Malpractice
- 2.19
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.11 | × 1.000 | 17.1100 |
| Practice expense | 6.74 | × 0.940 | 6.3356 |
| Malpractice | 2.19 | × 0.898 | 1.9666 |
| Total RVUs | 25.4122 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$848.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.11 | 1 |
| Practice expense | 6.74 | 0.94 |
| Malpractice | 2.19 | 0.898 |
(17.11 × 1 + 6.74 × 0.94 + 2.19 × 0.898) × $33.4009 = $848.79
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.
54324 billing questions
How does this differ from code 54322?
This code is for a midshaft-to-proximal penile opening with one-stage reconstruction. Code 54322 applies to a more distal-to-midpenile location.
How does this differ from code 54326?
Code 54326 is for a perineal opening with one-stage reconstruction. Use this code when the opening is in the midshaft-to-proximal penile region.
What documentation supports selecting this code?
The operative report should state the urethral opening's location and describe the reconstruction completed in one operation.
Is modifier 50 appropriate?
No. The CMS bilateral adjustment does not apply to this service, and modifier 50 is inappropriate.
How are related postoperative visits handled?
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?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; 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.
6,27654316,,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
6,28154328,,Revise penis/urethra,A,,16.47,6.64,NA,6.64,,2.12,25.23,25.23,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,28254332,,Revise penis/urethra,A,,17.91,6.93,NA,6.93,,2.31,27.15,27.15,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985