A circumcision may be performed as part of a surgical repair of congenital urethrogenital defects, most common of which is hypospadias. Hypospadias is a congenital anomaly resulting in the abnormal location of the urethral opening on the underside of the penis. Surgical repair of this condition places the urethra at the end of the penis and removes the foreskin if necessary. The foreskin tissue is sometimes used for grafting if the repair is extensive.

• Note that code 54105 is used to report a more complex procedure that involves the deeper layers of the penis and may require a layered closure, which may be separately reported. 
• Code 54150 is used to report circumcision using a clamp or other device, with regional dorsal penile or ring block. 
• Use code 54160 to report circumcision that uses surgical exci- sion other than clamp device or dorsal slit for neonate 28 days or younger.
• Adult circumcision-54161

– Use -52 modifier if w/o block – Do not separately report 64450 for nerve block
• 0 day global code • -25 modifier on associated E/M code (99239-25) • To support a separate and distinct evaluation and management service the day of the circumcision – Code the appropriate E/M visit in addition to the circumcision procedure - Add modifier –25 to the E/M code

CPT code 54160 denotes ‘surgical excision other than’ clamp, device or dorsal slit for infants 28 days or less, CPT code 54161 is for usage on patients above the age of 28 days. This code is more commonly used by urologists. Most urology practitioners prefer a surgical procedure, over usage of a device or clamp. The surgical excision procedure denoted by codes 54160/54161 provides a more precise excision of the excess skin, and oftentimes a better cosmetic outcome.
If the physician is repairing or revising and incomplete circumcision, CPT-4 directs us to use code 54163.

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