No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
54340 Hypospadias repair Medicare reimbursement rates in Washington
Reports the simple service level within the complicated hypospadias repair family when a urologist reconstructs the urethral opening and penile anatomy. Compare 54340 office and facility rates across CMS payment localities in Washington.
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 54340 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$523.77–$566.23
2 of 2 localities have a supported rate.
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 54340: Simple repair of complicated hypospadias
Reports the simple service level within the complicated hypospadias repair family when a urologist reconstructs the urethral opening and penile anatomy.
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.
CMS billing rules for 54340
- 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 RVU9.47 · 61%
- Practice expense (office) RVU4.90 · 31%
- Malpractice RVU1.22 · 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.
54340 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
This code describes a more extensive repair involving urethral mobilization and correction of chordee; 54340 represents the simple level in the complicated-repair group.
No office rate
Use 54352 for revision of a prior hypospadias repair. Code 54340 describes a different repair level, not specifically revision of an earlier operation.
Compare 54340 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.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$523.77
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$566.23
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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 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.
6,28154328,,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
6,28354336,,Revise penis/urethra,A,,21.08,8.08,NA,8.08,,2.71,31.87,31.87,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,28454340,,Rpr hypspad comp simple,A,,9.47,4.90,NA,4.90,,1.22,15.59,15.59,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,28554344,,Rrp hypspad comp moblj&urtp,A,,16.63,6.66,NA,6.66,,2.14,25.43,25.43,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,28654348,,Rpr hypspad comp dsj & urtp,A,,17.86,7.01,NA,7.01,,2.31,27.18,27.18,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,28754352,,Revj prior hypspad repair,A,,25.48,8.98,NA,8.98,,3.27,37.73,37.73,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00