CPT 54000
Global 010 ActiveSlitting of prepuce
CPT 54000 Billing & Documentation Guide
CPT code 54000 (Slitting of prepuce) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.55, a non-facility practice expense RVU of 3.26, and a malpractice RVU of 0.2, a total non-facility RVU of 5.01 and facility RVU of 3.14. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $172.19, though rates vary from $148.75 to $218.06 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 54000, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 54000 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 54000 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 54000
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.55 | 1.55 |
| Practice Expense RVU | 3.26 | 1.39 |
| Malpractice RVU | 0.2 | 0.2 |
| Total RVU | 5.01 | 3.14 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 54000
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $186.09 | $112.19 | $175.57 - $218.06 | 29 |
| Florida | $174.03 | $111.36 | $165.91 - $182.02 | 3 |
| Georgia | $163.72 | $104.14 | $156.86 - $170.58 | 2 |
| Illinois | $169.93 | $109.58 | $161.63 - $176.9 | 4 |
| Michigan | $163.42 | $104.77 | $158.73 - $168.11 | 2 |
| North Carolina | $157.63 | $99.36 | $157.63 - $157.63 | 1 |
| New York | $184.78 | $115.1 | $159.91 - $196.96 | 5 |
| Ohio | $157.92 | $100.89 | $157.92 - $157.92 | 1 |
| Pennsylvania | $166.03 | $104.85 | $158.04 - $174.02 | 2 |
| Texas | $165.46 | $103.97 | $157.06 - $173 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 54000
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 54000 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
Frequently Asked Questions, CPT 54000
What does CPT code 54000 mean? +
CPT code 54000 represents: Slitting of prepuce. It's in the Surgery (Urinary/Reproductive) category with a global period of 010.
What is the Medicare reimbursement for CPT 54000? +
The 2026 Medicare national average non-facility payment for CPT 54000 is $172.19. Rates range from $148.75 to $218.06 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 54000? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 54000? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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