No office rate
Both describe one-stage anterior urethral reconstruction; 54312 is distinguished by use of a free graft.
On this page
CMS RVU26D · Effective 2026-10-01
54308 Urethral reconstruction Medicare reimbursement rates in Vermont
Reports one-stage reconstruction of the male anterior urethra, such as repair of an anterior urethral defect or stricture during a single operation. Compare 54308 office and facility rates across CMS payment localities in Vermont.
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 54308 in Vermont?
Vermont 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
$621.06
1 of 1 localities have a supported rate.
Payment area: Vermont
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 54308: One-stage anterior urethral reconstruction
Reports one-stage reconstruction of the male anterior urethra, such as repair of an anterior urethral defect or stricture during a single operation.
This service reconstructs the male anterior urethra in one operative session to restore the urinary channel. Urologists typically perform it for an anterior urethral defect, including selected strictures or hypospadias-related anatomy, in a surgical setting. The operative method and extent depend on the defect; this code is distinct from a planned reconstruction completed in stages and from a repair specifically reported under a hypospadias code.
Choose the code when the operative report supports a one-stage anterior urethral reconstruction, and document the defect’s location and extent, the reconstructive method, tissue used, and completion in one session. 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 one session, the highest-valued is paid in full and others 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 54308
- 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 RVU12.30 · 63%
- Practice expense (office) RVU5.55 · 29%
- Malpractice RVU1.58 · 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.
54308 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 54316 when reconstruction is planned in stages and the service is the first stage, rather than a completed one-stage reconstruction.
No office rate
Use 54318 for the second stage of a staged reconstruction, not a reconstruction completed in one operation.
No office rate
54322 is the code-specific repair for simple distal hypospadias; 54308 describes one-stage anterior urethral reconstruction more generally.
Compare 54308 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
Vermont →
Office / nonfacility
Unavailable
Facility
$621.06
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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 54308 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,274
- Code
- 54308
- Physician work
- 12.30
- Practice expense
- 5.55
- Malpractice
- 1.58
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.30 | × 1.000 | 12.3000 |
| Practice expense | 5.55 | × 0.990 | 5.4945 |
| Malpractice | 1.58 | × 0.506 | 0.7995 |
| Total RVUs | 18.5940 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$621.06
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.3 | 1 |
| Practice expense | 5.55 | 0.99 |
| Malpractice | 1.58 | 0.506 |
(12.3 × 1 + 5.55 × 0.99 + 1.58 × 0.506) × $33.4009 = $621.06
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.
54308 billing questions
How is this distinguished from 54312?
Use 54312 when the one-stage reconstruction includes a free graft. Code 54308 describes the one-stage reconstruction without that free-graft distinction.
When is a staged reconstruction reported instead?
When the operative plan divides anterior urethral reconstruction into separate stages, compare 54316 for the first stage and 54318 for the second.
Does the 90-day global include related postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are payable 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.
6,27154250,TC,Nctrnl pen tmscn&/rgdity tst,A,,0.00,0.43,,0.43,NA,0.01,0.44,0.44,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
6,27254300,,Revision of penis,A,,10.92,5.27,NA,5.27,,1.43,17.62,17.62,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,27354304,,Revision of penis,A,,12.95,5.63,NA,5.63,,1.66,20.24,20.24,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,27454308,,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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817