Summary & Overview
CPT 54326: Single-Stage Hypospadias Repair with Urethral Reconstruction
CPT code 54326 represents a single-stage surgical correction of hypospadias with urethral repair using local skin flaps and urethral mobilization, potentially including circumcision and chordee correction. This procedure is a cornerstone of pediatric and reconstructive urology, addressing congenital urethral malposition and functional/ cosmetic penile deformities. Nationally, accurate coding and documentation for this operation affect surgical care pathways, billing clarity, and reimbursement alignment for hospitals and ambulatory surgical centers.
Key payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find concise guidance on the clinical scope of the code, typical sites of service, and the procedural elements covered by CPT code 54326. The publication also outlines common billing considerations, modifier usage patterns (listed separately), and how the procedure aligns with related surgical services.
The report is intended for billing professionals, surgical coders, and policy stakeholders seeking a clear national overview of this reconstructive urologic procedure, including benchmarks and billing context. Data not available in the input will be identified as missing where relevant.
Billing Code Overview
CPT code 54326 describes a single-stage surgical repair of hypospadias with urethral reconstruction using local skin flaps and mobilization of the urethra. The procedure may include circumcision and correction of chordee (abnormal penile curvature) when performed as part of the same operative session.
Service type: Surgical — genitourinary reconstructive surgery
Typical site of service: Hospital operating room or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 2-year-old male presents with distal hypospadias characterized by a ventrally displaced urethral meatus and mild chordee causing penile curvature. Prior topical preoperative assessment and counseling have been completed. The child is scheduled for a single-stage hypospadias repair under general anesthesia. The procedure includes urethral mobilization and reconstruction using local skin flaps, correction of the chordee when present, and an optional concurrent circumcision if preoperative consent is obtained. Preoperative workflow includes anesthesia evaluation, surgical consent (including discussion of possible need for staged repair if intraoperative findings require it), administration of prophylactic antibiotics per facility protocol, placement of a urinary stent/catheter for urethral support, operative repair with flap creation and urethroplasty, hemostasis, and postoperative monitoring in the recovery area with discharge instructions for wound care and catheter management. Typical follow-up includes early postoperative visit within 3–10 days and longer-term urology follow-up at 6–12 months to assess urinary stream and cosmetic outcome.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier used / default | Not typically appended; rarely used as an explicit modifier value in claims. |
11 |